Code blog: A Nurse's Perspective on Patient Care

Nicholas Genes, MD, PhD


November 17, 2005

In hospitals, "grand rounds" has a certain connotation. It's usually an early-morning talk given by an eminent speaker (and old friend of the department chair). The talk is dry, the coffee is bitter, the bagels are a day old. The students, residents, and attendings in the audience have their minds elsewhere, writing progress notes or revising clinic schedules. At the end of the presentation, there's polite applause, and the work day begins.

On the Web, "Grand Rounds" means something different: It's a weekly round-up of posts from various medical Web-logs (online journals called "blogs" for short). There are so many talented doctors, nurses, med students and other healthcare professionals blogging daily that it is hard to keep up with them all. Grand Rounds presents a weekly "best of the blogosphere," usually focusing on a particular theme. A different blogger is chosen to compile and host the listing each week. That person scours the Web for the best posts and combs through suggestions from other bloggers to produce the list.

Grand Rounds provides links to funny hospital tales, insights into medical research, and opinions on the latest healthcare news. Anyone who writes a blog is welcome to submit their writing for consideration, and for over a year now, people have been doing just that. Contributors include patients, nurses, administrators, scientists, students, and physicians. The writing may not be as polished as a mainstream media piece, but the first-person accounts from the front lines of medicine provide a dynamic perspective that is often missing from the news.

This week, Grand Rounds is hosted at code blog: Tales of a Nurse. This blog, run by a critical care nurse in California, has portrayed the nurse's perspective on patient care for almost 3 years. Nurses from around the world read and comment on Geena's tales, sometimes submitting their own stories. Whether it's a funny moment shared on a long shift, a poignant encounter with a patient's family, or a contentious issue in the nursing world, code blog is must-read material for anyone who wants to understand nurses.

Geena's site (not her real name -- she prefers to remain anonymous) grew out of a family-oriented blog, although she first had to resolve some concerns about posting personal material online.

"I had no idea why anyone would want to put personal content on the Web," she said. "An online diary? Weird. But then we realized that, since we don't live near our families anymore, they might be interested in what was going on with our lives. So, we started one of our own to post pictures and updates. One day, I wrote a funny story about something that happened at work...and kept writing about work every now and then. My friend suggested that I make a blog for nursing. I was apprehensive at first because I didn't know what I'd do if I someday ran out of 'material,' but started it anyway and am so glad I did."

Code blog has stayed true to its original goal since its inception:

"My purpose for starting the blog was to tell the world about what real nursing was like," Geena said. "In doing so, I was hoping that the world would go ahead and reciprocate by telling me what being a patient was like. I get stories from patients and have posted quite a few, but I do also enjoy submissions from EMTs and other nurses. I try to attain a balance between my own posts and story submissions."

Her audience obviously includes fellow nurses, even a few who know and work with her. But code blog also reaches out to patients and to doctors and other healthcare professionals.

"I've written a lot of posts for lay people," she said, "mostly about withdrawing futile care, about what roles a nurse fulfills, how many hats we wear, what goes on in 'a code.' It's heartening for me when people want to understand nurses and where we're coming from."

So, check out Grand Rounds this week at code blog: Tales of a Nurse (the link will become "live" on November 22, 2005, when the new Grand Rounds posts). While you're there, take the time to browse through her extensive archives for a taste of "what real nursing is like."

Be sure to tune in next week, too, when medical student Graham Walker hosts Grand Rounds at his blog, Over My Med Body.