Transcript of #RNchat for March 19, 2010. RNchat is a Twitter chat for registered nurses. Follow @RNchat (http://Twitter.com/RNchat) or visit http://RNchat.org for more.

1. rnchat: 15 minutes to #RNchat 8:30pm EST. Try using http://TweetChat.com or
http://TweetGrid.com for maximum R&B.
3/19/2010 20:15
rnchat: Welcome to tonight's #RNchat! If you're new just ask me questions or just watch. OK,
let's start with introductions. Tell us about yourself!
3/19/2010 20:30
oncnurse66: I am new to twitter and this is my first chat. My name is Becky and I am an Oncology
nurse and a BSN Nursing Informatics student. #rnchat
3/19/2010 20:31
rnchat: @oncnurse66 Welcome! Let me know if you have any questions. #RNchat
3/19/2010 20:33
rnchat: @oncnurse66 We may see a slow start tonight but by 9p we may see an uptick. #RNchat
3/19/2010 20:35
rnchat: T1 Outmoded Practices: What keeps outmoded practices from being retired? What blocks
innovation? h/t @Vaticuss #RNchat
3/19/2010 20:35
nursingpins: Hey all running late - busy at the hosp. #rnchat
3/19/2010 20:36
nursechenene: #RNchat T1 Rural providers that have been there all their lives and need to retire but
can't fill their positions.
3/19/2010 20:36
Kineticycle: #rnchat Fear of change keeps innovation from happening.
3/19/2010 20:37
nursingpins: The hospitals keep outmoded practices from going away - hospitals are the biggest
obstacle for nursing advancement. T1 #rnchat
3/19/2010 20:38
InfusionNurse: Hi all! T1 - Nurses have "that's how we've always done it, why change if it works" attitude.
Many r afraid of change/technology! #RNchat
3/19/2010 20:38
lorryschoenly: T1 We are all most comfortable practicing they way we originally learned and are
comfortable. It is 'safer' than changing..... #rnchat
3/19/2010 20:38
Kineticycle: #rnchat T1 Tradition is not an excuse for avoiding evidence based care, if u dont like
change, ur going to dislike obsolescence even more.
3/19/2010 20:40
rnchat: RT @Kineticycle: #rnchat T1 Tradition is not an excuse for avoiding evidence based care,
if u dont like change, ur going to dislike obsolescence even more.
3/19/2010 20:41
nursekama: Hello! Hope its not too late to join. My name is Kama and I'm a Clinical Nurse Specialist,
Psych/Mental Health, Southwestern Ontario #RNchat
3/19/2010 20:42
rnchat: @Vaticuss Welcome! Add #RNchat to your replies so we can see them them within the

2. stream. Join in and thanks for coming!
3/19/2010 20:43
oncnurse66: We work in a field that has to change with technology and updated evidence based
practice I don't think that we have a choice #rnchat
3/19/2010 20:43
nursechenene: #RNchat T1 We nurses have to stay current with profession to prove to facility change
need to implement evidence based.
3/19/2010 20:44
nursingpins: On change - nurses are going to need help running the hospitals - has become too much
to do it all. #rnchat
3/19/2010 20:44
Vaticuss: RT @Vaticuss But as educators are we holding on to the practices we cherish at the
costs of innovation? #rnchat
3/19/2010 20:45
nursechenene: #RNchat Amen to that.
3/19/2010 20:45
Vaticuss: RT @Vaticuss When we keep adding new practices without retiring old ones, are we only
adding to the frustration of our students? #rnchat
3/19/2010 20:45
nursingpins: Nurses have run the hospitals so long - many things nurses do are not nursing duties -
have done so long - now assumed. #rnchat
3/19/2010 20:45
StephenNP: T1 - Nursing is leading the evidence-based practice initiative - we all need to embrace
this culture and apply it to our practice #RNchat
3/19/2010 20:46
Trybarefoot: Evening #RNChat folks - just signing on - will hover a bit to catch up!
3/19/2010 20:47
nursechenene: Yes like calling the doctor's office for them and answering their pagers. Floored that a
facility still condones this practice. #RNchat
3/19/2010 20:47
nursingpins: Last time I looked - nobody was following - glad things are better there @StephenNP
#rnchat
3/19/2010 20:48
oncnurse66: @nursingpins the hospital where I work now requires nurses to enter patient charges for
services such as Sub Q injections #rnchat
3/19/2010 20:48
rnchat: @Trybarefoot Good to see you! #RNchat
3/19/2010 20:48
Vaticuss: @nursingpins How do you mean? What changes are you seeking? #rnchat
3/19/2010 20:49
rnchat: @nursekama Good to see you again! #RNchat
3/19/2010 20:49

3. nursingpins: @oncnurse66 Much of that is from the Diploma School days - when nurses were hospital
slaves - continues. #rnchat
3/19/2010 20:49
Kineticycle: #rnchat Welcome to all the new folks who have joined in tonight!
3/19/2010 20:50
Trybarefoot: I'm Gerard (Nova Scotia) - consultant in health/health care - previously Manager Primary
Health Care - work w/ RNs always! #RNchat
3/19/2010 20:50
maryannagordon: T1It's not for lack of effort from nrsg schools. We teach EBP, but new grads get
intimidated by seasoned nurses into doing old way #Rnchat
3/19/2010 20:50
rnchat: RT @Kineticycle: #rnchat Welcome to all the new folks who have joined in tonight!
3/19/2010 20:51
nursingpins: Nursing care is only a small part of what nurses do - nurses run the hospitals @Vaticuss
and spend very little time nursing. #rnchat
3/19/2010 20:51
Vaticuss: @nursingpins So how can we inspire change? #rnchat
3/19/2010 20:52
InfusionNurse: @maryannagordon T1 not all seasoned nurses r that way... #RNchat
3/19/2010 20:53
nursingpins: We must demand it a as group - no national voice - Unions are on the way for many.
hospitals are happy as things are. #rnchat
3/19/2010 20:54
Vaticuss: @maryannagordon So is it just a matter of time until those nurses are gone? We can
teach it for years but getting into action...? #rnchat
3/19/2010 20:54
nursingpins: Nurses can no longer run the hospitals and provide the care - has become too much - I'm
hoping EMR will help - but will not cure. #rnchat
3/19/2010 20:56
maryannagordon: @InfusionNurse of course not, speaking in generalities - but when new nurses don't feel
authorized to speak up, that's what happens #rnchat
3/19/2010 20:56
Vaticuss: @oncnurse66 And why is capturing those charges met with such resistance? #rnchat
3/19/2010 20:56
InfusionNurse: T1 - there's "personal" innovation - nurses wanting to change, but hindered by "process"
innovation #RNchat
3/19/2010 20:57
Vaticuss: @oncnurse66 Why us there so much resistance to capturing charges for services?
#rnchat
3/19/2010 20:58
nursechenene: As long as the EMR is not abused by the number crunchers by implementing more
charting windows to ease their stats configurations. #RNchat

4. 3/19/2010 20:58
nursingpins: Hospitals must hire (hospital management) people to do some of the non-nursing duties
we have assumed. #rnchat
3/19/2010 20:58
nursechenene: Otherwise an EMR is a great time saver #RNchat
3/19/2010 20:59
maryannagordon: @Vaticuss Maybe. Dont know. I think it has to be a concerted effort between nrsg
schools and hospital educatrs, EBP not going away #rnchat
3/19/2010 20:59
Vaticuss: @nursingpins But wouldn't CONVINCING be more effective than demanding? #rnchat
3/19/2010 20:59
oncnurse66: @vaticuss it takes so much more time you are trying to care for the patient while bein
hounded to charge for your "services" #rnchat
3/19/2010 21:00
nursingpins: If left to the hospitals - nurses will continue to do it all - It is taking mandates just to get
safe staffing! #rnchat
3/19/2010 21:00
rnchat: Sorry - left of the hashtag for our second topic. Apologies! Coming up... #RNchat
3/19/2010 21:00
rnchat: T2 NCLEX Difficulty: NCSBN is raising the bar. What do you think: does the bar need to
be raised? How are new grads doing? #RNchat
3/19/2010 21:01
Trybarefoot: Signing off all - not familiar w/ NCLEX or NCSBN (?) - so don't think I can contribute
much value - will look forward to next time! #RNchat
3/19/2010 21:02
nursingpins: T2 - great idea - the bar needs to be raised - new grads have no idea what they have got
themselves into - #rnchat
3/19/2010 21:02
Vaticuss: @oncnurse66 I can understand that. But the revenue generated by the charges
justifies/accomodates nursing positions? #rnchat
3/19/2010 21:02
mandirocker: @RNchat T2: A higher bar is scary for someone taking boards this summer :o/ but this
year my program brought in Kaplan, thankfully. #RNchat
3/19/2010 21:04
nursingpins: The switch from nursing school to staff is a shock - no relation to school and reality (re
staffing) #rnchat
3/19/2010 21:04
nexthospitalmag: RT @nursingpins: The switch from nursing school to staff is a shock - no relation to
school and reality (re staffing) #rnchat
3/19/2010 21:05
InfusionNurse: T2 - it is a licensure exam..think bar should always be high! #RNchat
3/19/2010 21:05

5. nursingpins: @Vaticuss that response is typical administration - nursing should not be responsible for
ALL charges. #rnchat
3/19/2010 21:06
Vaticuss: @nursingpins Hm. More than a measure of how the grads are doing, measures the
success of the curricular practices of colleges. #rnchat
3/19/2010 21:07
nursingpins: Nurses need more than accommodation. #rnchat
3/19/2010 21:08
maryannagordon: @nursingpins T1 no doubt, and we try to prepare them for that. We want to learn from
their preceptors, but want them to teach, too #rnchat
3/19/2010 21:08
InfusionNurse: @mandirocker ..good luck! #RNchat
3/19/2010 21:08
Vaticuss: @nursingpins So, what charges should rn be respnsbl for? #rnchat
3/19/2010 21:09
InfusionNurse: @Trybarefoot ..see you next chat. #RNchat
3/19/2010 21:09
nursingpins: T1 - I agree - nurses MUST teach the new ones - frustration is fueling a lot of our hostility
for each other. #rnchat
3/19/2010 21:10
nursekama: @InfusionNurse Does pre-licensure education address the transition experience? Are u
all familiar w/ NTF: http://tinyurl.com/ydjozfh #RNchat
3/19/2010 21:10
Vaticuss: @nursingpins FYI: Im not administration! :). #rnchat
3/19/2010 21:10
rnchat: Final topic coming up in a moment! #RNchat
3/19/2010 21:11
maryannagordon: @Vaticuss T1 I agree, curriculum must change to ensure new grads meet the needs of
hospitals. I'm at OHSU, our OCNE curriculum tries #rnchat
3/19/2010 21:11
mandirocker: @nursingpins I agree, I have had experience with both floor nursing as a Nurse Extern &
School Clinical....MAJOR difference. #RNchat
3/19/2010 21:11
nursingpins: @Vaticuss -Sorry. #rnchat
3/19/2010 21:11
maryannagordon: @nursekama great resource, thanks - will pass on to my students #rnchat
3/19/2010 21:12
rnchat: RT @nursekama: @InfusionNurse Does pre-licensure education address the transition
experience? Are u all familiar w/ NTF: http://tinyurl.com/ydjozfh #RNchat
3/19/2010 21:12
oncnurse66: @vaticussT1 The computer program should automatically charge for the services when

6. the sub q injection is charged #rnchat
3/19/2010 21:12
rnchat: T3 Happy Certified Nurses Day!: What are the things you most appreciate about what
CNAs do (or have done) in your practice? #RNchat
3/19/2010 21:13
rnchat: Please note: you may continue to discuss any topic if another one starts, just ad T2, etc.
#RNchat
3/19/2010 21:13
Vaticuss: @maryannagordon And I agree. But what can be cut? Who is willing to let go of hospital
corners, rolling gauze, iv drip rates... #rnchat
3/19/2010 21:13
nursingpins: Nurses could not get by without CNAs - underpaid and under appreciated. #rnchat
3/19/2010 21:14
maryannagordon: T1 for those not familiar with OCNE (Oregon Consortium for Nursing Education) I suggest
read about it at http://ocne.org/ #rnchat
3/19/2010 21:14
InfusionNurse: @nursekama ..that's a great resource for new grads...is it only for Canadian grads?
#RNchat
3/19/2010 21:14
Vaticuss: @oncnurse66 See, now that is innovation! Great response! #rnchat
3/19/2010 21:14
Vaticuss: @Vaticuss Its not like colleges have a lot of fluff in the curriculum. #rnchat
3/19/2010 21:16
RNMark: Dudes! Here for my dose of ADD/ADHD! #RNChat
3/19/2010 21:16
maryannagordon: @Vaticuss T1 OCNE curriculum doesn't teach any of that. Focuses on what students will
need to know in real world, uses simulation #rnchat
3/19/2010 21:16
rnchat: @RNMark Hope we have enough of the good stuff ;) #RNchat
3/19/2010 21:17
InfusionNurse: T3 - still new (only 2nd yr) so didn't do much but to send cards and emails.. #RNchat
3/19/2010 21:17
nursekama: T2 @InfusionNurse I don't see why the resources wouldn't be applicable to American
grads...check out transition theory. :) #RNchat
3/19/2010 21:17
Vaticuss: @maryannagordon Sounds progressive! #rnchat
3/19/2010 21:18
InfusionNurse: LOL....RT @RNMark: Dudes! Here for my dose of ADD/ADHD! #RNchat
3/19/2010 21:18
davedawes: #RNchat Sorry I have only arrived! Late night RCN meeting. Are we on T3 already?
3/19/2010 21:18

7. maryannagordon: @Vaticuss OCNE let go of teachng every single thing. Instead, we teach a few things
deeply (CHF, DM, MI, HTN), most frequently seen #rnchat
3/19/2010 21:19
InfusionNurse: @nursekama T2 - wow, impressive...http://www.nursingthefuture.ca/transition_theory
#RNchat
3/19/2010 21:20
nursingpins: @InfusionNurse that is funny -re: ADD/ADHD - really LOL #rnchat
3/19/2010 21:20
maryannagordon: @VaticussT1 yes, is 1st of its kind, other states now modeling curricula after it - duel
enrollment between comm. colleges & OHSU #rnchat
3/19/2010 21:21
Vaticuss: @maryannagordon Any measurement stats to support this method? (said hopefully!)
#rnchat
3/19/2010 21:21
InfusionNurse: @davedawes ..kinda all over the T's..1-3... #RNchat
3/19/2010 21:21
RNMark: @maryannagordon OCNE model makes sense but risks loss of broad integrative thinking.
Maybe not now but someday. #RNChat
3/19/2010 21:21
maryannagordon: @RNMark disagree. Based on Tanner's Model of Clinical Judgment, it's ALL about broad
integrative thinking, putting it all together #rnchat
3/19/2010 21:23
nursingpins: Good night all, got to run - thanks Phil - later #rnchat
3/19/2010 21:24
Vaticuss: @InfusionNurse Sry. Prolly my fault. It's my first time. (blush) #rnchat
3/19/2010 21:24
RNMark: @InfusionNurse My TweetModel: Show up>blather>enjoy feeling of failure :) #RNChat
3/19/2010 21:24
rnchat: @davedawes You can discuss any topic actually, but we are on T3 - http://bit.ly/9w6Gxc :)
#RNchat
3/19/2010 21:24
Vaticuss: @RNMark Ha! #rnchat
3/19/2010 21:25
maryannagordon: also guilty, 1st time - will try to be better about T1, T2, T3 and blathering! #rnchat
3/19/2010 21:27
InfusionNurse: @Vaticuss ..oh no...as @philbaumann said we can continue to discuss any of the
topics..glad to see u here! #RNchat
3/19/2010 21:27
rnchat: @nursingpins Have a good one! #RNchat
3/19/2010 21:27
mikeskobba: In the NICU the certified lactation nurses really push practice and support families in

8. breast feeding. #RNChat
3/19/2010 21:27
rnchat: Wow! Our hour is almost up! Crazy! #RNchat
3/19/2010 21:28
InfusionNurse: @nursingpins ..night, have a good weekend!! #RNchat
3/19/2010 21:28
rnchat: @Vaticuss It's cool... Twitter chats are confusing at first, but you'll be hooked :) You can
try http://TweetChat.com #RNchat
3/19/2010 21:28
InfusionNurse: LOVE it!!! LOL..RT @RNMark: @InfusionNurse My TweetModel: Show up>blather>enjoy
feeling of failure :) #RNchat
3/19/2010 21:28
nursechenene: #RNchat I enjoy it.
3/19/2010 21:28
rnchat: Before we wrap up, what parting ideas or thoughts would you like to share? #RNchat
3/19/2010 21:29
Vaticuss: @maryannagordon Double ha! :). #rnchat
3/19/2010 21:29
maryannagordon: @rnchat oh, is it only for an hour? Wow! Cool connection, any idea how many people
watch/participate? Same group every time? #rnchat
3/19/2010 21:29
oncnurse66: Nite all. I enjoyed my first time on #rnchat #rnchat
3/19/2010 21:30
InfusionNurse: Is it true that only a wet baby likes "change"?? LOL...j/k! Thanks for a great chat!! See
you all RNchatters!!! Good night! #RNchat
3/19/2010 21:31
rnchat: @oncnurse66 Glad you could make it to #RNchat tonight! Stay tuned to upcoming times.
:)
3/19/2010 21:31
rnchat: BTW: we're putting #RNchat on Facebook http://bit.ly/9LDwwP & LinkedIn
http://bit.ly/9PYs2K - Fan and connect.
3/19/2010 21:32
maryannagordon: @Vaticuss T1 we just graduated 1st BSN cohort last June, 2nd group graduating soon -
research on new grad capabilities ongoing #rnchat
3/19/2010 21:32
Vaticuss: @rnchat Parting thoughts: I really am going to try to use "blather" more often. Thanks
Mark! #rnchat
3/19/2010 21:33
nursekama: Thanks everyone! Looking forward to the next #RNchat
3/19/2010 21:33
rnchat: @maryannagordon I'll have to sort through to get numbers, but the constitution varies,

9. keeps evolving. Yes, super fast hour! #RNchat
3/19/2010 21:33
rnchat: THANK YOU everybody for showing up! Transcript for tonight's chat will be up soon. Next
chat is Tuesday 3/23 12pm EST! #RNchat
3/19/2010 21:34
InfusionNurse: @philbaumann..thanks for moderating, great job! Glad to see new and "been here, done
that" friends on here.... #RNchat
3/19/2010 21:34
Vaticuss: @maryannagordon Lots of potential in that model. Will be looking for future
measurements! #rnchat
3/19/2010 21:35
rnchat: @InfusionNurse Yes, me too. Always nice to see you here! :) #RNchat
3/19/2010 21:36
Vaticuss: @InfusionNurse Good night all. #rnchat
3/19/2010 21:36
RNMark: @maryannagordo concerned that limiting scope of studies creates artificial limits based on
awareness of options. #RNChat
3/19/2010 21:36
maryannagordon: Enjoyed the chat, everyone, looking forward to the next! Thanks, I'll actually try to
"blather" less next time! #rnchat
3/19/2010 21:37
rnchat: @maryannagordon We love blather! ;) See you next time! #RNchat
3/19/2010 21:39
rnchat: @Vaticuss Good night! #RNchat
3/19/2010 21:39
rnchat: @nursekama Thank you - enjoy your weekend! #RNchat
3/19/2010 21:40
RNMark: @maryannagordon OH NO! Blather is Best Part: separates humans from rest of food
chain, lawyers, etc. #RNChat #RNChat
3/19/2010 21:41
oncnurse66: RT @nursingpins: T2 - great idea - the bar needs to be raised - new grads have no idea
what they have got themselves into - #rnchat
3/19/2010 21:49
maryannagordon: @RNMark my husband always quotes Shakespeare, "first we kill all the lawyers!" (he
went to law school!) Blather atcha next time! #rnchat
3/19/2010 22:18
SwedishCareers: RT @rnchat THANK YOU everybody for showing up! Transcript for tonight's chat will be
up soon. Next chat is Tuesday 3/23 12pm EST! #RNchat
3/19/2010 22:37
SwedishCareers: YES! RNs tweet & FB! Yay! RT @rnchat BTW: we're putting #RNchat on Facebook
http://bit.ly/9LDwwP & LinkedIn http://bit.ly/9PYs2K
3/19/2010 22:38

10. JennyBizRN: RT @nursingpins: The hospitals keep outmoded practices from going away - hospitals are
the biggest obstacle for nursing advancement. T1 #rnchat
3/19/2010 23:20