In the last four years my inbox has changed from being something I would occasionally check and infrequently get messages from friends. Recently my inbox has become something I compulsively check and that can dominates my life. The worst part is that even though I often check my email, and find things I need to do, the emails will just sit there and pile up.

So this summer I am vowing to change that, or at least to try something new. That something is Inbox Zero, and was thought of by Merlin Mann. After noticing that others struggle to do what he does, continually empty his inbox, Merlin decided to teach others the tricks. The simplified message is that ever email needs to be dealt with as soon as you open it by applying 1 of 5 options:

• Delete
• Delegate
• Respond
• Defer
• Do

Looking at the list it seems simple and obvious enough, but every nursing student and nurse I know is guilty of ignoring these rules. The compulsion is to open our email, check it and if it is important enough or we have time do something. If not the email will sit there and pile up.

Being a student I rarely have the option of delegating. However, I regularly need to do things, and yes it is true we don't always have time to do things immediately. That is why the To Do list was invented. Now a new problem, I have 3 scraps of papers, three napkins and a dozens of stickies with random lists of things I need to do. This requires further organization. Another smart individual is David Allen, who wrote Getting Things Done. His basic premise is as soon as we think of something to do it needs to go on a to do list. That way we can put all the stress and worry out of our mind and focus on tasks. So combining Merlin and David's advice, I downloaded Things. Now when ever I get an email, if I have to do something, even simply "respond to John Doe" it goes on my To Do list.

Although it doesn't seem like a big deal. This has taken a lot of effort, but has already started to pay off. I feel less stress when I open my inbox, because I know what to do with emails that bring more work because  I have a system to organize my work. Also, when I have time to work on things I don't open my inbox, and get flooded by more emails with things to do. Instead I go to my To Do list and start getting the satisfaction of ticking things off that list.

As a nursing student, adopting a great system for managing emails as well as To Do's is critical. There will be hundreds if not thousands of emails that nursing students will open about paying tuition, getting reference checks, course selections, clinical placements, and who knows maybe even grade appeals, none of which need to stay in your inbox. Find a way to file them, even if you just archive them. Just get them out of you inbox and dealt with.

Nurses could also benefit from reducing the amount of email they have in their inbox. Nurses are always dealing with a lot of information and an over flowing inbox is not something nurses need.

Recently I've been asked to write a book for the series "The Nurses Advantage." As you may, or may not, have guessed from the title the point is to help explain different topics (Communication, Etiquette) that are useful to nurses. The basic format is to run through the basics, in a largely question and answer format as well as providing tips through out the book. In preparation I wanted to ask for outside input of questions that you would like answered. Although this book is targeted towards nurses the answers will be broadly applicable to healthcare providers and healthcare related organizations. Below is a simple form to submit and I will try answer as many questions as I can in the book. Any answers that don't go in the book I will try to put on Nursing Ideas.

After launching this website in 2008 through word of mouth and search traffic Nursing Ideas has continued to slowly grow. Lately things have been picking up a bit more speed and reaching new heights. This year for Nursing Week Nursing Ideas was feature in the Toronto Star and just this week and article was published by Yonge Street Magazine about how I started the website and the motivation behind it.

This means I need to say thank you. To the people that have supported and mentored me, to the people that have found this website and told others, and those of you who have been encouraging me the whole way. I truly appreciate it and I couldn't have done this without you.

iPad Apps for a Nursing Student

If you want to be a technology evangelist then you need to understand the technology. That and a hundred other half baked justifications (excuses), a bit more student debt, one expensive trip to the Apple store and this nurse has an iPad.

In all seriousness I want to test the iPad's usability and see if it has a felt (since I can't 'measure') impact on my workflow. The product is only weeks old (in Canada), and there are already some fantastic applications and more on the way.

For now I'm starting with:

Productivity iPad Apps

Good Reader: PDF/document viewer. I have been using it to sync research reports that I need to read. I sync 1-5 for fun, and then stacks (20+) when I'm writing about a particular topic so I can flip through them on the subway.

Evernote: I was not a big user of Evernote until the iPad. This application syncs notes, which can include photographs/screenshots, audio (20 minute intervals) and video attachments. I like this for tracking ideas (this blog post for example), random thoughts, project materials, and to file some of the random things I like yet don't have a place for.

Things: This is a expensive To Do list manager and a bit for project management, I'm sure you could get better free ones, but this one syncs with the paid for apps (iPhone/iPad/Desktop), which is mandatory for my lists.

Pulse: A fantastic visual viewer for RSS feeds

Kindle: Free app for eBooks, this is fantastic. I'm not sure about you, but I am definitely an optimistic packer- meaning whether on vacation or a trip to school I will bring extra books just incase I get time to read them. Now I have the books I want to eventually get through on more than my night stand.

Clinical Resources iPad Apps

Epocrates: Provides information on drugs and a range of options from FREE all the way to $199 a year.

Universal Doctor Speak: Don't be scared off by the name of this app, it is really a translator for basic in clinic conversations and has potential for nurses as well. It provides english to French, Spanish or Chinese, as well as some speech options. This allows you to point to an instruction so patients understand your questions/instructions.

Web MD: This app allows you to check out symptoms, drugs and basic first aid information. Useful for interest and to recommend for patients. Interesting to see what patients are able to learn and find out without health care providers.

Health Related iPad Apps

Sleep Cycle: Fascinating app that lets you track the quality and length of yourself. Sleep is very important for nurses and nursing students, this app allows you to measure you average sleep and set an alarm that tries to wake you up when you are coming out of a deep sleep cycle. I also wonder what it would be like to have this type of functionality for out patients, it would be extremely useful to know how much rest they are actually getting. Think about how much we wake up our patients, if we knew they were in a REM cycle perhaps we could wait the extra half our before getting them up for a bath or round of medications.

Lose It: Another important health measure is out daily calorie and nutritional intake, and again this app could make a great addition to our electronic health records. Image your patient handed you a detailed report of their daily, weekly, and monthly calorie intake and weights. Much better than the traditional pen and paper 24 hour system we often use. I also know a lot of nurses that use this app on the iphone once they book their flights to warmer climates.

On June 7th 2010 I attended Ryerson's Nursing Research day, it was a fantastic day and there were some great presentations. As nurses continue to increase their research efforts and knowledge translation events like this become more important. It was great to hear the research that was happening, within the university and the international visitors that were presenting there as well.

For those of you that have an website Editz.com is something worth considering. There are two reasons that you might want to use it, because writing is not your favourite thing to do (or your best talent, like me) or you want others to help you find your typo's  and grammar errors (lets face it they bother us).

Editz is a simple application for your website, that allows anyone to quickly and easily provide you with writing critiques and corrections. Instead of having readers that a writhing in pain, from your misuse of simple punctuation and spelling, they can simply point it out and you can easily fix it. This is what most people like to call a win-win situation. The best part is there is a third winner, the next reader to come by your site also has an easier time digesting what you have to say and won't get distracted by a mistake the last visitor already pointed out.

If you have a blog or your own personal website, take a look and see if it is right for you.

The word "unconference" gets a mixed reaction from many, in healthcare it is usually more confusion then skepticism. For those of you that don't know, the unconference was born out of the technology industry. They are about 4-5 years old depending who you ask, and they focus on participation by attendees. The wikipedia article on unconferences says they are

a facilitated, participant-driven conference centered on a theme or purpose.

Anyway, on Friday, May 28th 2010 I took part in organizing my second unconference called Mental Health Camp Toronto. This conference was a result of Anne attending Health Camp Toronto, and wanting to have one for her Mental Health. A few collaborators later (Madalyn, John, Carlos, and I) and we were on our way.

Although the unconference was born out of the technology industry, it provides an interesting model for participation, collaboration and knowledge transfer (if you want to be technical) for healthcare. I remember going to ChangeCamp, an event and community movement started by Mark Kuznicki to cultivate citizen participation and openness in government. Below is a short video of Mark explaining what an unconference is and how it might be useful in healthcare.

The crazy part is that, it takes the normal model of a committee of 10-30 people that make decisions (speakers, panels, etc) for hundreds of attendees and flips it on its head. With 5 people, we raised thousands of dollars and simply provide a space and food for participants to come together to talk about mental health, social media and anything that attendees wanted to discuss.

Needless to say, after many meetings at the Duke of York, Massey College, and the Centre for Addiction and Mental Health, the skype calls and a few hundred... maybe a thousand emails somehow it all came together. The event went incredible well and we were so happy to see our 'baby' born in 8 months.

Dr Nancy Walton - @researchEthics

Ryerson University

Associate Professor - Daphne Cockwell School of Nursing
Chair - Research Ethics Board

As many nurses begin to learn about patient care and research the topic of ethics comes up, or at least it should. In this interview I sit down with Nancy Walton, a nurse that found her love for ethics while pursuing her graduate education. She was the Associate Director at Ryerson University in 2009 and is the chair of their Research Ethics board. As an ethicist and a nurse Nancy understand difficulties that both sides encounter when they met. That said she is passionate about helping nurses to understand and use ethical reason to solve situations that arise in patient care and to plan their research. Although her career track to tenure has the traditional list of publications and academic work she is also using more accessible methods of writing through her website Research Ethics. In this interview we talk about her work, the importance of ethics for nursing, how nurses can get more involved and learn more about ethics.

Resources

• Joint Centre for Bioethics
• Research Ethics Blog
• Nursing Ethics - Codes of Ethics
• College of Nurses - Practice Standard Ethics
• Nursing Ethics (wikipedia)
• Institutional Review Board (IRB) Blog

Questions

Dr Nancy Walton RN: What do you feel would help you to further engage with ethics? How can educators and ethicists make it more accessible?

Rob Fraser RN: Have you ever taken ethics training? How was ethics taught to you?

I often wonder why individuals and organizations in healthcare have really taken to the social media and usually look down on "blogging".  Perhaps it is caused by mainstream media's mentioning of twitter or others promises of what social media will do for healthcare.

If you cringe at the thought of your organization blogging or even raise an eye brow consider this, a blog is simple a chronologically organized content. A blog does not have to involve personal feelings, pointless rambling, or any other misconceptions you might have. In fact there are many reasons that a blog might be the PERFECT fit for your organization. If you want to develop web traffic, keep stakeholders informed of projects, share vision and values, or describe 'things to come' so that people are aware of what you working on then a blog is a great fit.

After a recent search of Canadian nursing organizations' websites I realized very few, if any, had a blog, news or updates section. I have two suspicions why this is, first no one wants to be in charge of the project and second no one wants to great more work for themselves or others. To counter this I would say 99% will not have to do (much) more work. Why? Because every organization is already generating the content that is almost perfect for this.

Walking through hospitals I constantly see newsletters, every few months I get numerous bulletins and magazines, I open my computer I get dozens of updates from organizations, and attending annual general meetings I sit for hours hearing about the things the organization has been working on. Every single one of these things is taking time to share what your organization is doing, and for some reason very few healthcare organizations are taking time to do this online line.

This is costing the organizations in different serious ways. First, for every hour that it might take to develop anyone of the previously listed things it might take a 10 minutes to make an internet posting out of it. Organizations are simply losing out on the chance to get significantly higher return by a small increase of effort into something they are already heavily invested in. The second thing the organization is losing is web traffic. This costs the organization the chance to tell their members and the public what they are doing. Increased content on an organization's website increases the search traffic for the entire website too. So although not ever article will being thousands of readers slowly increasing content helps more people find out about the work they are doing and services they offer.

If healthcare organizations are serious about getting on the web and engaging their members as well as the public they need to increase their online presence. Creating a blog is a simple and easy way to do this. Before beginning to walk you need to crawl, similarly before taking on highly complicated forms of social media healthcare organizations need to start with the basics.

May 31, 2010 Toronto's St Michael's Hospital showcased the Research Advancing Practice's (RAP) [2009 PDF] latest cohort. The program involves a group of frontline nurses that enroll in a program that gives them to time to learn and conduct research. Behind the program is Dr. Lianne Jeffs (see Lianne Jeff's Nursing Ideas interview here) and takes in nurses like Martha Schroder (her interview here). The program is fantastic on so many levels, it promotes a culture of learning, allows nurses to improve the workplace, job satisfaction is enhanced and most importantly the research focuses on improving patient care!

When I heard the date for these presentations was announced I marked off my calendar I knew I wanted to go, but when I got there there was something different. This year the nursing RAP (what a great name!) had a new abbreviation, the RAPpers (as they are called) took part in RAP-CD (career development). During the opening remarks it was explained that Janice Waddell had been working on integrating the Donner-Wheeler career visioning into the program. Although at first glance it might not appear a large addition. Career development is not a new topic, but to nursing the incorporation of CD into a program that is already doing incredible things this addition is very significant. Nurses that participate expresses a number of positive outcomes, and one of those is an interest in further education. When nurses are given the opportunity to learn, conduct research, and improve patient care it really improves they way they view their role in the hospital, including the CD ensures that nurses not only consider further education but also their future career.

Watching the nurses talk about their experiences, research, and what they hope to do in the future was inspiring. Rarely on walking into a hospital is it possible to walk into a room of energized nurses talking about how excited they are, how the organization is supporting them, and creating future dreams about what they would like to do. Below are some pictures from the day, I highly encourage you to take a look, consider if your organization might be able to do something similar, and finally to remember that nurses are the frontline of healthcare delivery, which gives us the best perspective to come up with great research questions.

The RAP-CD initiative is a fantastic idea. I truly encourage every nurse and nursing organization to consider if this is a possibility. Creating dynamic programs like RAP-CD create amazing opportunities to support employees and improve patient care!

This post was an email from Carolyn Newstrom

I saw this on Twitter today and just had to share it here with you. There is a tie-in to nursing here…big time.

I think this video explains the huge missing link between hospital administrators and nursing. Nurses would love their job so much more if they were given the opportunity to be creative (create), find automony (self-direct), find purpose, and add meaning to what they do 8-12 hours a day. Right now their job is so filled with a set of prescribed tasks that they sometimes feel they need more money in order to “make it all worthwhile”. As a profession, I think we may be stuck back at the level of “carrot & stick” due to the fact that it *is* so task oriented. Although more money is a good thing, in this day and age, it’s also a hard thing to come by. It seems to me that patients (and indirectly, organizations) would benefit so much more from a nursing team who felt good about what they do, felt invested in their job, and were getting a great deal of satisfaction from the work they do. There is a way to get there. I’m sure of it, but it would require a cultural shift at the organizational level which is not an easy task.

Is there a way we can tap into this principle, expand upon it, and perhaps spread the word?

With regards,

Carolyn

This post was written by Phil Baumann and originally posted on his website.

Image via Wikipedia

What? You’re kidding, right? I thought that nursing was behind the times and that nursing is supposed to learn about social media. What possibly could the Social Media elite learn from nursing?

I am flipping things around. Actually, in light of all of the online tips and strategies on how to incorporate social media (SM) tools into your life, there is one simple process all nurses use that can be applied to social media. After all, both nursing and social media are about people (right?) The process is an algorithm that all nursing students abhor and almost all nurses ridicule. It’s called the Nursing Process. It’s a fancy phrase for using common sense in practice.

It’s a simple, stepwise approach to clinical problem-solving. You all use this method everyday but just aren’t so full of yourself to actually give it a special name.

(Official historical note: A long time ago in a dimension far away, nurses who suffered from physician-envy decided to come up with their own professional method. The nursing process is the result of that complex.)

So here’s the algorithm, also known as ADPIE:

1. Assess your patients’ (SM substitute: clients, audience)
2. Diagnose your patient’s response (SM substitute: what does your market want/need? – what problem do my clients want me to help solve?)
3. Plan your patients’ care (SM substitute: marketing efforts)
4. Implement your care plan (SM substitute: execute your marketing plan)
5. Evaluate the care you provide (SM substitute: analytics, trends, subscribers, comments, etc.)

Simple, isn’t it. Common sense, that’s all.

Work your plan. Plan your work.

Whenever you’re working on your blog, consider using this simple method. Use it at every step of your marketing process, whether it’s a profit-making business, a non-profit organization, a grassroots movement or your own personal or professional branding.

If your blogging or other social media projects are anemic, undergoing a lethal cardiac arrest or are just not feeling good, try ADPIE. Once a day or as needed.

My fellow nurses who are reading this post are probably laughing their butts off. But maybe for us this is a way to turn something that we’ve come to regard as complete BS into something useful outside of the bizarre world of health care.

For you who aren’t nurses, here’s your chance to be a great clinician for whatever social media ventures that matter to you.

This is one thing social media can learn from nursing. Are there any others? I can think of some, but I just ate dinner.

Let me know if this is a useful approach. Whatcha think?

This post is written by Terri Schmit and posted on her blog. She is an experienced nurse practitioner, educator, and is currently finishing her PhD. This is one of her many great posts.

Anyone that  has recently written a paper, made a presentation, or has simply been doing research knows that you can end up with a ton of references to manage. During my undergraduate I constantly battled managing course readings, research results, and personal readings that I had. Most people try to develop a system that will help them to manage it, and I have tried a few such as EndNote, and RefWorks. Once you organized them reading them was the next challenge. In an environmental age should we print articles? I constantly misplaced or excessively highlighted copies so I turned to programs such as Skim (which I still love) and Papers (which also organizes references). No system was perfect, but they helped. However, last fall I fell out of love with them all.

In 2007 Mendeley became the new kid on the block combining reference management, share, discovering reading and reading. In addition to all of these features the program is FREE and allows you to share and collaborate! Now no program is without its flaws, but Mendeley sure does come close. In the following videos I demonstrate why I really like this program and why you should consider using it.

Mendeley Screencast

Creating a Free Account

Finding Profiles and People

Building your Library and Collections

Favourite Features

So now that I've shared what I think of Mendeley, what do you think?

Nursing Week is an opportunity. Many people will take time this week to thank nurses, recognize what they have done, or simply to get to know what it is that we actually do. Depending where you are time is spent doing different things, from selling raffle tickets to bringing in pizza, cake, and coffee to nursing units. Often as nurses we take time recognize others or simply sit back and enjoy. However, Nursing Week is an incredible opportunity for explaining why nursing work is important, as my friend Suzanne Gordon says nurses save lives and do a of a lot more than simply "care" about our patients. During Nursing Week we have a captive audience and nurses need to take advantage of it.

Advocating for patients, medicare, and the profession can be done in a number of ways. You can consider writing an article to post online, submitting an editorial to a newspaper, or an interesting story from your organization to a journalist. One thing that the Registered Nurses Association of Ontario has been promoting is "Take Your MPP to Work Day". Inviting your local, provincial, state or federal politician to spend a day (or a few hours) with nurses is just one way to help them understand our work and our patients.

On Monday, 10 May 2010 MPP David Zimmer took time out of his morning to have breakfast with the RNAO Region 6 & 7 members. Hosted at the Free Times Cafe, nurses enjoyed a delicious buffet breakfast, a short talk, and fantastic discussion with David Zimmer. It was a fantastic opportunity to give suggestions, raise issues, and share our questions. The morning was a fantastic success, and it was great to spend time with other nurses.