Jan 01, 2012
Blogging the Nursing Life
The first thing you should know about nurses who blog is that they are serious about the nursing profession. They may tell a story that makes you laugh out loud, they might describe a heart-wrenching event, and they may even gripe about work. But they wouldn’t, after a long shift, sit at a desk and tap away on their computer keyboards if they didn’t care.
[Jan. 6, 2008] How do you explain?
I’ve sometimes found it very difficult to come home and act as though something emotionally earth shattering hadn’t just happened. . . . After witnessing and being a part of a profound moment in someone’s life, it feels like you literally have to take some time and process it and honor it in a way before you can get back to your normal life.
You may recognize that feeling. And that’s the whole point of blogging: sharing one’s thoughts and experiences in regularly updated journal-like entries that are posted chronologically on a website.
Jenny Edwards, a psychologist by training, is now a stay-at-home mom in a community in Massachusetts. “I discovered blogs after my third child, sitting in front of the computer pumping milk. I happened on nursing blogs, and they are my favourite, I think, because of the morbid sense of humour.” Edwards is so impressed with what she reads that she says that if she were to “start all over again,” she’d become a nurse.
Not every non-nurse blog reader will want to enter the profession, but the RN who’s behind codeblog believes that blogging is a way to let the public in on what being a nurse is all about: “People have no idea. I think they expect us to serve ice water on a tray. But if they read, they will see how difficult it is, and they will understand the emotional part of being a nurse.”
For nursing students, blogs can also be a portal into the real world of the profession. Matt Cardwell, 27, is an undergrad at McMaster University and spends most of his life in the classroom. “In school, everything is in a system, cut and dried….Blogs give you an idea of what to expect when you graduate. I have found a rich world out there.”
[Sept. 17, 2011] Priorities, seriously
So I got called into the Boss Man’s office this morning, because the floor wrote me up and he wanted to address the issue. At this point, my feet hurt, I haven’t peed yet tonight, I didn’t get to eat anything, I have blood on my scrub pants (which I just now noticed), I have poop on my scrub pants (which I just now saw but have been suspiciously smelling for the past two hours), I haven’t finished charting on that last arterial bleeder that came in, and my coffee from 7pm is still sitting full on the counter next to my computer. It’s been a rough night.
Mary Anne Cumming has also found an informal education in the nurse blogs she reads. But she is not a student or a newbie: she’s an RN with years of experience. She likes to read about areas of nursing she isn’t familiar with, and the Nurse Ratched’s Place blog is a particular favourite: “Psychiatric nursing was never my forte, and I love the way she writes about what nurses are faced with in that area. I have learned a lot.”
Cumming, who works in a recovery room, has written a blog from her home on Vancouver Island since 2006. A Place I Call Home(latitude49.blogspot.com) blends nursing and personal stories with photos of life on the West Coast.
“I come from a large family,” the 50-year-old says, and blogging started “as a way to keep in touch before Facebook came along.”
In contrast to many nurse blogs, which are “set” inside a hospital, the outdoors plays a key role in what Cumming chooses to write about. “My nursing and my personal life are so interlinked. I like to share what I am passionate about on my blog, whether it be fishing out on the ocean, hiking up Mount Arrowsmith or holding the hand of someone who is dying.”
Dean Giustini is a biomedical librarian at the University of British Columbia’s branch library at Vancouver General Hospital. He blogs extensively on social media in health care (blogs.ubc.ca/dean). Giustini notes that Cumming “infuses her blog with a lot of personal information. She reveals herself, and I think that is one of the original reasons blogs became so popular, because people talk about their feelings.”
In addition to “personal” blogs like Cumming’s and others profiled in this article, there are institutional blogs and blogs strictly for disseminating information. Other blogs are primarily promotional and are one of an array of social media used by an author or entrepreneur to market a product or service. However, these blogs don’t attract the same loyal readership as personal blogs.
The popularity of blogging took off about a decade ago. It’s still going strong and has evolved to the extent that bloggers can now post YouTube videos.
Facebook and Twitter, which allow for more interactivity, have lured away some bloggers — or divided their attention. But these newer social media serve different purposes. Twitter posts, or tweets, are limited to 140 characters; they are rarely used to tell a story. However, they can include links to blog posts, drawing visitors and inviting a wider readership. And many bloggers appreciate the control they maintain over their blog, with none of the intrusions that characterize a Facebook page: one blogger told Canadian Nurse she didn’t like Facebook because people “fiddle” with her page. Another advantage of blogs is that their writers can measure their popularity by tracking the number of “hits,” or visits, they get.
Giustini explains an appeal of blogs for readers: “A compelling writer can raise important issues, so blogscan be educational and make readers feel less alone. Whenever you have an opportunity to see what other people really think, it is important.” And, he adds, “I enjoy people trying to be creative. It sometimes triggers my own creativity.”
[July 1, 2011] Another missed opportunity
So here I am today spending yet another Canada Day working....Don’t get me wrong, I love my job, I am not complaining about that....[but] Sometimes when I see the bright eyed nursing students come in all perky and eager I wonder if they really know how their lives will change when they get into this profession.
There is something gratifying about following the chronology of a blog (the word blog is a contraction of web log). Because posts are archived, you can dip into early posts and the experience feels like sneaking a look at someone’s personal journal. Edwards says reading nurse blogs is completely engaging: “Over the years, a few bloggers have disappeared — when they found other work or ran out of things to say — and that always makes me so sad.”
The Internet is littered with dead blogs because of the many who write regularly for a while and then run out of steam. Google a term like “25 top nursing blogs” and you’ll find that a lot of them are no longer active; the links provided on blogs you like — typically listed under the generic title “blogroll” — are a much better gateway into this world.
Cumming is rare among bloggers, because she agreed to be quoted by name. Most prefer to remain anonymous, as this allows them to write about events at work, while changing enough details to protect patient confidentiality (and their own).
“My best friend at work knows, but I’ve told her I’ll take her first-born child if she tells anyone,” says the RN behind Those Emergency Blues (torontoemerg.wordpress.com). She is “exquisitely careful” to protect confidentiality when writing about her employer and her patients, and no one at work has ever suspected that she blogs.
The informal Healthcare Blogger Code of Ethics (medbloggercode.com/the-code) states that bloggers must declare their professional training, protect patient identities, disclose if they have any commercial ties to health-care products, refrain from personal attacks and correct any errors that are detected. Not all nurse bloggers have signed on to the code, but no one would suggest contravening its tenets. Health privacy laws already legislate the requirement to protect patient identities, and other stipulations are addressed in professional ethics or are simply common sense.
[July 31, 2011] So when does this become a crisis?
I walked into the Emergency Department one hot morning a couple of weeks ago and found every last stretcher — twenty-five beds, including the two we try to reserve for trauma or codes — was filled with admitted patients; furthermore, five additional patients were waiting for consultants and likely admission. We were operating at 120% capacity even before the usual gamut of ED patients would begin flooding in. Trying to manage an ED under these circumstances is like walking through an open field holding an umbrella during a thunderstorm. You know lightning is going to strike, and you hope like hell it doesn’t strike you.
Torontoemerg began blogging in 2009. Her blog has evolved from “stories of crazy patients to larger issues. I am completely dedicated to the nursing profession, to bringing the holistic perspective about what a patient needs to the whole discussion about health-care reform.”
Those Emergency Blues gets about 600 to 700 hits a day: “Ontario’s health minister follows me on Twitter, and I’m hoping she reads the blog, too. It’s democratizing that there is such access to politicians through social media.”
One of the most popular features on her blog, which can be called up from a tab at the top of her home page, is Maxims for New Graduates. These words to live by include “Housekeepers and ward clerks are your best friends. Treat them as such,” “You will make errors. Learn from them” and “Sixth sense counts. Ignore it at your peril.”
Torontoemerg allows visitors to leave comments on her posts, which she values: “I get a lot of inspiration from them. Sometimes people point me to a topic to write about — and, of course, it’s nice to know that you are not writing into a void.” Nurse bloggers also tend to comment on other blogs, attracting readers back to theirs. “You want to have people read what you write, so you need to always think of ways to draw them in.”
Robert Fraser, 25, is an RN who recently completed a master’s degree in nursing, specializing in administration, at the University of Toronto. In 2008, he launched nursingideas.ca, a site where he posts video interviews with nurse leaders, researchers and innovators. It’s a format that effectively communicates their passion and dedication. Fraser also has a blog, which he uses to share ideas about nursing research and aspects of social media rather than missives from the front lines.
His book The Nurse’s Social Media Advantage eases nurses into a world that intimidates many of them. Social media provides “new possibilities for building relationships, creating content, finding and sharing information, and collaborating with others,” he writes. The way ideas are communicated and shared “will continue to evolve, whether nurses get involved or not. The only risk is that our profession will be left behind,” if it doesn’t embrace the technological advances.
Fraser wants bloggers to understand that anonymity on the Internet is not guaranteed. “I generally discourage anonymous blogging,” he says. “I think it provides a false sense of protection.” He points to a lawsuit in the U.S. a few years ago that unmasked a physician blogger.
Torontoemerg says that she’s familiar with Fraser’s point of view and has thought about revealing her name. “But I have documented extensively how elderly patients are treated in our system — many of us have hobby horses, and that is mine — and I don’t want to lose my power as a whistleblower.”
Both Cumming and torontoemerg say they are especially gratified when younger, less experienced nurses contact them for advice about nursing issues. One who e-mailed torontoemerg is the 25-year-old behind New Nurse Insanity (themountainsarecalling.blogspot.com), who works in emergency care on the east coast of the U.S.
[Sept. 5, 2011] Badasses
But really, the ER that is portrayed on TV is a super high octane, go-go-go nothing but excitement all the time environment. In reality, it’s not all that badass. For every freaky random lawn decoration leg impalement I take care of, we see a hundred toothaches. For every time someone goes into a v-tach arrest in the department and gets shocked back to the land of the living, I argue with fifty drug seekers. For every gunshot resuscitation, I give five enemas. For every EKG that prints out tombstones and sends the patient directly to the cath lab, I start IVs on thirty vague belly pain patients. For every statistic I just gave you, I made 100 percent of them up.
The nurse blogging world is phenomenally diverse (and overwhelmingly American), but it appears to be inhabited by a disproportionately large number of emergency room nurses. “I think it is because we see such ridiculous stuff,” says New Nurse Insanity. “And I may see 15 to 20 patients a shift.”
She began writing her blog as a form of de-stressing when she was an undergrad (her blog’s former name was Student Nurse Insanity). “I just wanted to get my feelings and thoughts out,” she explains. At the time, she also got hooked on reading nurse blogs “because it was so exciting to be able to see into that world.” She still regularly reads about 15 other nurse blogs and looks forward to one day meeting some of her favourites in person.
That’s a goal that Gina, who writes codeblog, achieved when she went to the BlogWorld convention in Las Vegas in 2009. She was thrilled to meet the nurse behind emergiblog, who is as vivacious and energetic as she imagined from reading the blog.
Gina, 36, is a long-time blogger who lives in California. Hers is the first link to pop up when you Google the words nurse and blog. (She credits her husband as the family’s social media wizard.)
A strong believer in the blogging community, she says it has been strengthened through sites that feature postings of medical-related blogs by a variety of writers. These “best of” sites are sometimes called grand rounds or blog carnivals.
[July 31, 2011] So when does this become a crisis?
…the sudden arrival of a trauma or a patient coding in the waiting room means a scramble to find room; in a scenario when seconds count, delay could be disastrous if there is no available bed to treat them. I don’t actually think the general public understands the fine line emergency department nurses and physicians walk between successful outcomes, where the patient is treated, made well, and discharged, and the morgue. Every health care professional in the ED practices with their heart in their throat and their licences over the fire.
Gina, unlike most bloggers, derives some income from her blog. A recent post she wrote about pill crushers — an amusing, illustrated history of these devices — is being reprinted by Reader’s Digest. Gina is mystified by the choice: “I have written some heart-wrenching things, and that is what they want to reprint?”
She also accepts some advertising. Bloggers told Canadian Nurse that they are bombarded by e-mail pitches to place ads on their sites in exchange for small sums linked to the size of their readership.
Many don’t accept ads. “I’m not into advertising,” says Cumming. “If my blog helps your nursing career, helps you write a paper, gets you thinking…that’s fine.” Giustini says he, too, is approached by companies offering him a cut if he agrees to advertise their products on his site, but he always refuses.
Gina shifted from full-time to part-time work in an intensive care unit after she had her two children. Her blogging changed, too. She took a break from it in 2006, and now writes when she feels like it.
New Nurse Insanity, on the other hand, is still going strong. She works nights and writes when she gets home in the morning. “All the ideas and quotes are still fresh. Usually the catalyst is something that was said, and then I build a story around it. The quote will be similar in tone, and I combine patient experiences.”
After almost three years on the job, she says she writes more for others than for herself. “I enjoy the sense of community and the act of writing. I also want to help people understand that there is a lot more to nursing than just stress. It is an intricate, in-depth job, and it takes a decision to do it well.”
Warning! Searching for good blogs can be addictive. A tip for reducing your browsing-through-the-Internet time: find a few blogs that you like and then follow their links to others. Here is a sampling of some popular blogs to get you started:
This oncology nurse shares poignant stories about her work with patients with cancer. Some will bring a tear to your eye.
At Your Cervix
This RN works in labour and delivery in a Pennsylvania teaching hospital and has been blogging since 2006. The posts are informal and lively. See June 16, 2011: Things you won’t hear your L and D nurse say (but she’s thinking them). The site boasts a live traffic feed, which announces your arrival.
Nurse practitioner Terri Schmitt, who is pursuing a doctorate in nursing while working, doesn’t blog all that often, but her posts are well written and interesting. Read I lost it, from June 25, 2011.
Erica is an ER nurse who calls it as she sees it. Click on her “Greatest Hits” posts, listed on the side of her blog page, and you’ll go from thoughtful (Low-tech healing, May 25, 2006) to simmering annoyance (What the triage nurse is really thinking, Feb. 8, 2007).
This blog belongs to Kim McAllister, who has been in nursing for more than three decades, began blogging in 2005, got her BSN in 2010 and is now working on a master’s in nursing. Check out her Aug. 3, 2011, post: So, you really want to be a nurse?
Nurse Ratched’s Place
The psychiatric nurse behind this blog has been writing off and on since 2006. Her posts are a combination of snippets of nursing history (with accompanying photographs) and bulletins from the front lines.
Nurse Jo has been writing her wry, candid, sometimes angry, sometimes heartbreaking posts since 2004. Sample I’m tired of this body. Can I trade it in? from Nov. 1, 2011.