dan's blog

What are those sounds?

You can set alarms on tasks.  They ring when the task is past due.  That is, you will hear a kind of ringtone if the task's deadline arrives before you've marked the task done.  This is a much-appreciated feature for busy nurses doing many things at once and wanting to make sure everything is on time.  But why do they sound like that?

What makes a sound suitable for this purpose is a matter of taste -- everyone's is different! -- and we're happy to add one if you request it.

Our first beta test: flying colors!

We have successfully completed the first of several software beta tests. The site was a busy surgical hospital in Nebraska. Four nurses (Andrea, Bridget, Cathy, and Raime) used the software intensively for four consecutive 12-hour shifts (Andrea and Cathy in two day shifts; Bridget and Raime in nights). We learned a lot, caught and repaired some bugs, and are most encouraged by the positive outcome. Here are a few observations.

Ok, they're protocols

Since the beginning of this project, we've fretted about correct terminology in the medical context.

We are building a to-do list manager with timings. Everybody understands those words in ordinary work contexts but in healthcare there is specialized terminology. Fortunately, we found clarifying definitions in Gooch and Roudsari, "Computerization of workflows, guidelines, and care pathways: a review of implementation challenges for process-oriented health information systems," JAMIA 18:6, Nov. 2011.

What makes a good nurse great?

Above all, safe practice.  That means forgetting nothing, remembering and doing all the steps of every procedure, protocol, and care plan.

Empathy.  Conveying that sense of sincere caring, being sensitive to emotional states and needs, and taking the time to sit with patients, listen to them, or simply be with them.

In praise of pit crews

Dr. Atul GawandeMay 26, 2011 -- Today I watched one of my heroes, Atul Gawande, speak at Harvard Medical School's commencement. He talked about needed changes in the culture of healthcare providers, usually meaning doctors (he is one). He said that what winning race teams need -- even more than daring drivers -- is well-trained, well-coordinated pit crews.

Why am I doing this?

Why am I doing this?  Why start a company, take responsibility for other people's jobs and pay and investors' money, design a product that has no guarantee of success, risk failure?

Why not go back to bedside nursing, collect a steady paycheck, and be done with my work when I go home?

Let's stop eating our young!

People are amazed when I tell them that -- despite nursing's aura of high tech -- for on-the-job data tracking, nurses rely on a mere piece of paper.

They call this piece of paper their "brain". Each nurse invents her own format (see examples in our brain museum).

Sharing of best practices is rare. Time and information management techniques are not taught nor even mentioned in nursing schools.

Seeing nursing with a computer programmer's eyes

In my previous career I was a computer programmer. As an RN, I returned to that technology for help with information-related tasks of nursing. Nurses must carry so many details in their heads as they do their work. This makes it more stressful and error-prone than it needs to be. Why not get some help from technology?

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