Simple Solutions

On-line FAQs help

Nurse designs web site for common questions

Mark Hammerschmidt, RN, has seen orientation programs come and go during his 21 years of nursing. But when his large, New England teaching hospital (it requested not to be named for this story) lost its clinical educator for the medical intensive care unit (MICU), Hammerschmidt was asked to help out.

"One of the senior staff had the idea of starting unofficial teaching classes for the new orientees in the interim, and I volunteered to produce handouts for her to use in classes," he says. The result is an on-line file of FAQs — frequently asked questions — that can be printed or accessed via computer by new hires or existing nurses who need to brush up on a particular topic.

His employer is happy to make use of his skills — although what he does isn’t considered "official" — and the site (www.geocities.com/markhammerschmidt/) now contains 15 peer-reviewed files that contain an in-depth look at topics from intra-aortic balloon pumpings (IABP) to localizing infarcts.

"The idea sort of popped into my head," he says. "The problem seemed to be that the new nurses were very overwhelmed by the MICU, which only makes sense, since we are very much the high-tech, ultra-sick population kind of place. Breaking up the topics that needed covering into small chunks seemed helpful. You can hop around in a FAQ and pick out the parts you’re looking for with ease if the question lists are formatted the right way."

In the year since Hammerschmidt — a senior staff nurse at the hospital — started the program, the hospital hired a new clinical nurse supervisor who has been very supportive. "I produce a file every month or so. I hand it first to my wife (who is also a nurse). Then it goes to other senior staff in the MICU for comments." (See table.)

Sample Contents of a FAQ File: Defibrillation

1. What is fibrillation?
1-1: Atrial fibrillation
1-2: Ventricular fibrillation
2. What is defibrillation?
3. What is cardioversion?
4. What is a defibrillator?
4-1: monitor
4-2: capacitor
4-3: numbered buttons 1,2,3; output dials
4-4: paddles
5. How do defibrillators work?
5-1: What is depolarization?
5-2: What does electricity have to do with it?
5-3: What is a joule?
5-4: What is monophasic defibrillation?
5-5: What is biphasic defibrillation?
5-6: What is "transthoracic impedance"?
6. How do I cardiovert someone?
6-1: Cardioverting a-fib
6-2: Cardioverting VT-with-a-pressure
7. How do I defibrillate someone?
7-1: Defibrillating VT
7-2: Defibrillating VF
8. What bad things do I have to watch for during cardioversion or defibrillation?
8-1: Using synchronization correctly
8-2: Keeping the process orderly
8-3: Clearing the bed
8-4: Using contact gel properly — contact burns
9.  What things should I do after the cardioversion defibrillation?

Source: Mark Hammerschmidt, RN, Marlborough, MA.

 

Specialists are consulted

Sometimes, it goes to specialists, such as the IABP staff who are most familiar with balloon pumping, he notes. "I figure the files are never really finished, which is only right, as the art of nursing continues to develop all the time," he says. "The pressors and vasoactives file got updated a while back to include vasopressin."

Hammerschmidt says his biggest goal was to help new hires understand that there is always help at hand. And it didn’t hurt for the more seasoned staff to have ready access to help, either. He adds that he enjoys sharing knowledge, and having the chance to focus on topics that are of interest to him specifically. "People have also started stumbling across the web site and sending in notes from places such as New Zealand, Australia, Texas, and Florida. It’s astonishing."

The real lesson, though, isn’t something that Hammerschmidt wrote about already. It’s that he took an interest and developed it. "Find something about your job that interests you and get to it," he says.

Next on the list, Hammerschmidt deadpans to his e-mail list of supporters: "maybe Acute Coronary Syndromes’ — or Not-so-Cute Coro-nary Syndromes.’ Then maybe What if my patient . . . ,’ organized by system, starting with neuro, and working southward. Thanks for all the encouragement — this has really been, and continues to be, a lot of fun."

(For more information, contact Mark Hammerschmidt, RN, five Stone Hill Road, Marlborough, MA 01752. E-mail: markhammerschmidt@yahoo.com.)