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Palliative Care and the Human Connection: Ten Steps for What to Say and Do [Video]

I saw this video for the first time two weeks ago via TheONC. The video is absolutely worth another mention as it sheds light (quickly) on a daunting topic – delivering difficult news.

What do you think? Will you (or do you already) utilize this method in your practice?

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Giddy Up; Submit Your Abstract to the Cowtown Oncology Symposium

Screen Shot 2013-09-09 at 7.27.54 PMYeehaaaw! It’s time for the 4th Annual Cowtown Oncology Symposium in Fort Worth, Texas.

I am a Texan – born and bred. Contrary to popular belief and pervasive stereotypes, I don’t routinely say yeehaaaw, still, the Cowtown Oncology Symposium is so fun and enlightening that it’s worth breaking out my Southern drawl, Y’all.

The planning committee cordially invites you to submit your abstract on oncology, radiation, hospice, and palliative care nursing trends for poster presentation by January 31, 2014. Submission guidelines are below, so giddy up!

COS Poster Abstract Submission Guidelines

P.S. And, if presenting isn’t your thing (which it totally can be your thing no matter your level of leadership!), you should definitely attend the Symposium. It’s set in beautiful and historic Fort Worth on the fabulous Texas Christian University campus.

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I Heart Algorithms

I’m not sure when it happened, but it seems like algorithms and “pathways” have overtaken healthcare. I’m not complaining; I love it. I’m a visual person, so when people explain processes to me, I tend to draw them as I’m listening or reviewing my notes. I’ve found that algorithms turn gray processes and care to black and white. They clarify exactly what everyone can and should do rather than leave that information in one person’s head. I frequently make – and revise – algorithms. They’re easy, artful, practical, and just plain smart work.

AlgorithmI make algorithms one of two ways – in Microsoft Visio or in Microsoft PowerPoint. You could also use Microsoft Publisher, but I prefer not to use it for algorithm creation simply because I know PowerPoint shortcuts and tools much better. Visio is intended to develop algorithms and pathways. It’s incredibly easy to use (especially if you know how to use PowerPoint or Publisher) and takes all the guesswork out of making straight lines and centering text. If you don’t have Visio but make a lot of algorithms (or are planning to do so), purchasing Visio is well worth the investment. No, Microsoft Visio is not paying me for this article; I just love Visio that much. I know, it’s geekily comical. I am unashamed.

If you don’t have Visio, you can still develop your algorithms in PowerPoint. It may take a little longer than Visio, but hey – it works. Open a blank file. You’ll only need to use one PowerPoint slide for this. Start adding your quadrilateral shapes, overlaid text boxes, and add in arrows. Capture or highlight all the items on the slide, group them, and then right-click to save the file as a picture to then insert into other documents. It’s pretty easy once you get the hang of it.

Do you use or create algorithms in your healthcare setting?

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From A Map of the Uninsured to Unplugging Every 90 Minutes: A Nursetopia Reading and Education Mashup [Part 13]

MashupHere’s a smidgen of the goodness I’ve been reading and watching this week:

What are you filling your brain with currently?

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The Sacredness of Tears

A sweet friend shared this quote with me several years ago. I often think about it, and I most certainly thought about it a lot this week as people within my organization – people I love working alongside – learned of my move to another healthcare system and we shared conversations of the past, present, and future.


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Urine/Stool Collection Containers: Why Do You Call It A ‘Hat?’

I’m currently doing some additional work to educate nurses on colorectal cancer. It’s a topic I’m passionate about not only in work but also in my personal life as my family has felt the effects of colon cancer. I’ve even blogged about my own experiences with fecal occult blood test, or FOBT, stool collection. Maybe a little TMI, but hey…nurses have these issues, too, and that’s important for people to know!

My mind keeps drifting back to a conversation I had with a sweet friend not too long ago…about why in the world is the urine/stool collection container called a “hat.” I can’t help but laugh each time I think of the conversation because it is a bit ludicrous. Yes, it kind of resembles a hat – maybe one that has been chopped in half? Nurses and other healthcare providers nonchalantly tell patients about “the hat,” but I’ve never had anyone mention that verbiage aversion to me until my friend brought it up.

I’ve tried – unsuccessfully – looking for the origin of this jargon. Does anyone know or have a guess? Are there any other created terms you think we use in healthcare that we use in “normal” conversations that might be a wee bit odd to non-healthcare providers?

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Two Free PowerPoint Templates to Liven Your Next Presentation

I’ve had my fair share of stale PowerPoint presentations. Trust me, I’ve given many of them, too. I find the presentations I enjoy the most have clean aesthetics, minimal text, and provide opportunities for storytelling. Considering I like those things in presentations, I choose to present this way, as well.

Notepad and TapeI had the lovely opportunity to speak on behalf of the Nurse Oncology Education Program to a group of nurses and nurse faculty at the beautiful Moncrief Cancer Institute in Fort Worth on Saturday. One presentation was directed for faculty on how to make oncology content “stick” in undergraduate curricula, something I’ve grown passionate about as a result of working with faculty over several years. The second presentation was about colorectal cancer screening.

ScreenBoth topics can be rather dull, so I try to make the content come alive in any way possible – mostly with stories, vocal tone, and creative PowerPoint backgrounds. In preparation for the presentation, I couldn’t find any background I really liked, so I just made my own with simple shapes, lines, transparency settings, and colors. One of the nursing faculty members asked for the templates, so I thought I’d share, share, share in true Nursetopia fashion.

You can download the “Notepad & Tape” PowerPoint template here and the “Screen” PowerPoint template here. (Any large, unused space likely included a picture.) Enjoy!

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Long-live Your Nerdy Passion

I recently attended a conference that made me smile because each speaker discussed his or her passion. It was evident in their enthusiasm. I smiled because the passions aren’t what we typically think of when we talk about passion.

For example, Greer Gay, from the American College of Surgeons Commission on Cancer, loves to read the Federal Register. Say what? The Federal Register is a daily summary of the U.S. Government, complete with all the sections and subsections anyone would ever want to set their eyes upon. Ms. Gay has a healthcare politics background, and her work is impacting cancer programs across the U.S.

Again, at the same conference, Ian Thompson, MD, spoke about prostate cancer and screening. It was clear he is passionate about the prostate and ending that cancer. He’s devoted his life’s work to that cause.

Another friend of mine has a husband who works with mass spectrometry. Had I heard of it? Sure. Did I have any clue what it really meant to me as a nurse and general consumer of mass spectrometry-influenced devices? Uhm…no.

The radiologist that attends our tumor board conferences can not only read imaging study after imaging study, but he knows the inner workings of an MRI machine like he’s rebuilt it himself.

These people – and several others – made me think about the uniqueness of our passions – they are all different to some degree. And, I am thankful for that. The topics alone are meh, but when passionate people talk about the topics, they come alive; something changes. It’s the beautiful mystery of callings and missions and purposes.

So, whatever your passion is, I hope you fan the flame. Go ahead, nerd it up. Make the subject come alive to others. Be the difference.


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Low Health Literacy Strikes A Nurse’s Home

According to the Institute of Medicine, “health literacy” is more than just being able to read; it is “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”

medicinelabelHealth professionals – even myself – speak a completely different language than the rest of the world. Yet, we’re shocked most of the time when patients don’t understand what we’re saying. We expect people to somehow know “PO” means by mouth, or we keep our processes the same – like keeping prescription bottle labels in one language even when we know a patient may not be proficient in that language. Heck, deciphering a prescription medication label is difficult for people (smart people) who speak English.

I found this out the hard way when my husband misread a medication label for one of our children. The instructions just didn’t compute, and I had to re-educate him. Now, my husband is educated, thoughtful, and a good communicator. With three children, we should have an in-home med cart at times; he gives our kids medicine just as much – if not more – than I do. He’s familiar with teaspoons and tablespoons. To me, the label was perfectly clear, but not so to him. Thankfully, the kiddo was under-dosed, and there was no safety concern.

It happened in my home. I guarantee low health literacy is much more prevalent than you think. You can easily assess health literacy and patient understanding via the Teach Back Method. Give it a try this week and see how your patients do – how well they understand what you’re telling them. It’s shocking.

Considering health literacy is the strongest indicator of a person’s health – stronger than age, income, employment status, education level, and race – and nearly 88% of the population with less-than-proficient health literacy, we must do better. Nurses can make a tremendous impact with patients and health literacy. Many states and organizations are working on this complexly simply problem – to ensure patients understand what healthcare professionals tell them. Search to find the statistics in your area as well as what efforts are happening to increase health literacy in your community.

Your community needs you to help; your patients need you to help.

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Ethical Reasoning and Online Social Media

The Article: Englund, H., Chappy, S., & Jambunathan, J. (2012). Ethical reasoning and online social media. Nurse Educator, 37(6): 242-247.

Big Idea: While nurses and nursing students frequently utilize social media, little research has been done to understand nursing students’ own understanding of the ANA’s Principles for Social Networking or their accountability for their social media posts and how they relate to the ANA Code of Ethics. After experiencing an increase in students’ unprofessional use of social media, researchers at the University of Wisconsin Oshkosh surveyed their first semester and last semester undergraduate nursing students using a 21-item survey corresponding to the nine provisions within the Code of Ethics.

Survey Says!: 124 nursing students completed the surveys. Mean ages of the two semester groups were young – 22.4 and 24.4 years of age. The convenience sample was predominantly female, and the two groups – first semester and last semester students – had significant differences in their understanding of ethical decisions to not post certain information. Be sure to view the original article for the specifics of all the tests.

Quotable: “The increasing use of social media sites by nursing students has opened a ‘‘Pandora’s box’’ of issues related to ethicality and nursing professionalism in a cyber world” (p. 243).

“Although the CON [College of Nursing] has a policy in place, unfortunately, results of this study indicated that 27.5% of the sophomore 2 students and 30.4% of the senior 2 students were either unaware or unsure if the CON had such a policy. Clearly, more effective methods are needed to ensure that students are aware of the CON’s social media policy” (p. 247).

So What?: The stories of nurses and nursing students (and other healthcare professionals/students) misusing social media are everywhere. This study indicates nursing students have varying levels of understanding of ethical boundaries while using social media and that it is a learned skill. Perhaps nursing schools and programs should more heavily focus on this skill early in the curriculum to circumvent future issues.

This study could be easily replicable in any nursing school in the world. In fact, the authors encourage others to use their tool to further validate the survey. Every nurse should reach out to his alma mater to make it aware of this study and the tool as it just might shed some light on this highly unstudied yet incredibly needed area of research.