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For more than 13 years, I have used a variety of handheld devices at the point-of-care that have helped me deliver better, safer evidence-based nursing and advanced practice nursing care. In a previous article I discussed my many years of using Palm devices and my eventual migration to the iPhone in the past year.

I’m often asked by nursing and medical colleagues exactly how these devices help me deliver better and safer care. I prefer to think of my iPhone and other similar handheld devices as my “ectopic brain.” My original in-situ brain often works well and even surprises me at times with what I’m able to recall in the heat of the moment. But at other times it starts to show its age and grinds along like a rusty contraption on its last legs. My “ectopic brain” is always there to help bail me out.

My day typically begins at 0700 with the blaring iPhone alarm. I get up to make sure my girls are up and getting ready for school. I log onto the Internet through my iPhone using the Safari app and check my local newspaper and television station for breaking stories. I check my e-mail through the iPhone—mostly junk, but a few important ones sneak through. They are either filed to their respective folders or responded to and then filed.

Over breakfast, I click on the Facebook icon and see what my friends from around the world are up to. By now I’ve gotten a few text messages and have responded back. The rest of the morning is spent reading e-mails, responding to texts, updating my cache of memos using the Memos app to assist me at my job as Acute Care Nurse Practitioner in my busy community emergency department.

I also click on CalenGoo, the app that syncs with my Google Web-based calendar, to check my schedule of events for the day and next several days.

Other useful apps –>

Image: Hemera | Thinkstock

After 11 years of being a devoted Palm device user, I have now fully transitioned to using my iPhone exclusively for all of my “ectopic brain” needs. Since 1999, I’ve been using Palm company products, starting with the Palm V (which I still consider to be the most aesthetic handheld device ever), then the VX, the 500, the 505, the 515, the Tungsten C and finally the Palm TX. Each new Palm device saw significant improvements in function, memory, expandability, color screens and bigger screens, all without ever losing its very friendly user interface.

Two years ago, I purchased my first iPhone as I saw Palm wasn’t advancing its product in a way I desired. I knew the iPhone wasn’t quite what I wanted, either, but there was a hint of promise there—a vision of what could possibly be.

I gradually began finding applications for the iPhone that replaced functions on my Palm TX and I began using the TX less and less. Epocrates came out, so I didn’t need the TX for that. Various medical calculators came out for the iPhone. I was able to find an application (Memos) that allowed me to convert all of my years of memos created for the Palm (more than 1,200 of them!) to a format that I could easily transfer to the iPhone. The application even provided foolproof instructions on how to do this. Now I had all of those tips and tricks for emergency medicine and emergency nursing on the iPhone.

There was just one last issue: the calendar. I have to admit, I find the native iPhone calendar very un-user-friendly. Even the native Palm calendar is only just okay. I had gotten used to a program for Palm called Datebook (through all of its variations…3, 4, 5 and finally Datebook 6). It’s so perfect! It allows you to assign colors and icons to your events. It allows for repeating events by date or day of the week. You can link events in the calendar to your contacts list. And it has multiple views: by day, week, two weeks, month or year. And it’s so intuitive!

I couldn’t really find its duplicate for the iPhone, and through communication with the creator of Datebook, I learned that he was not planning an iPhone version. Darn the luck!

But then I found Informant. It doesn’t have all of the functions of Datebook 6, but it’s the closest application I’ve found that “acts” like Datebook. I can assign colors and icons to events. It has multiple calendar views and repeating events. And although it’s not as “pretty” to look at as Datebook 6, it does allow me to now just carry one device as I hit the floors of the busy emergency departments where I work. I now have everything on my iPhone that I had on my Palm TX and more.

Sorry Palm. It was nice for 11 years and I don’t think I ever had a more user-friendly device. You just didn’t keep up with the demands that your devoted users were asking for.

Image: Jupiterimages | Creatas | Getty Images

Greetings everyone! New apps are appearing all the time, so I thought I’d compile an updated list of my top 10 iPhone applications for nurses.

These are applications that I believe have the potential to make the art and science of nursing easier for us, the clinical nurse.

So without delay, and in no particular order of preference…

Top 10 iPhone apps for nurses

1. Fast Facts – The Kathy White Fast Facts library is now made for the iPhone! A slew of valuable emergency and critical care information is right at your fingertips. No more carrying around her very good (but sometimes bulky!) handbook.

2. MedCalc – A free medical calculator. Correct sodium for hyperglycemia, calculate body surface area and much more.

3. Pedi-STAT – Do you work in a pediatric ER or ICU or take care of potentially ill children? Pedi-STAT is for you. Think of it as a length-based color-coded tape for the iPhone. Input child’s weight or height and instantly access tube sizes and drug doses for many critical situations.

4. Infuse – A revamped version of the old Palm-based InfusiCalc (which will be coming to the iPhone in the near future) allows you to input all of your hospital’s drug concentrations, and you can quickly, easily and reliably calculate infusion boluses and drips.

5. Nursing Central – From Unbound Medicine, a leader in Palm applications for several years, this app carries Davis’s Drug Guide, Davis’s Laboratory and Diagnostic Tests, Diseases and Disorders, Handbook of Nursing Diagnosis, Medline journals and a Taber’s dictionary.
6. Lytes – A quick review of electrolyte disorders, clinical findings and treatments.

7. iMurmur – A very nice review and collection of heart sounds. Bone up on these and impress the cardiologists!

8. VisualDx – Having a hard time figuring out rashes? I know I do. VisualDx allows you to build a differential diagnosis of rashes by simply inputting your findings and patient information. Helps narrow it down quickly AND provides treatment information.

9. Epocrates – The “basic” version, which is available for free, allows you to always have up-to-date drug information at your fingertips. The annual subscription version also provides information on diseases, infections, pill identification, medical calculators and tables of pertinent, clinical information.

10. Eponyms – Don’t recall what Virchow’s triad is? Look it up as well as more than 1,000 other eponyms with this free (to students) or otherwise inexpensive application. It’s perfect for a working stiff like me!

Image: eponyms.net

Trying to wade through all the techy talk about smartphone apps for nurses? Here’s a quick review of an indispensable application called “Eponyms” by Andrew Yee, MD, that is a must-download for every nurse.

What it is

“Eponyms” is a very comprehensive database of, well, eponyms. Eponyms are names given to disease processes, anatomical structures, clinical findings, etc., that are named after their discoverer or the person in whom the disease was first found. (Personally, I hope to never have a disease called “Bowman’s Disease”! I want to be famous, not infamous.)

“Eponyms” software is available for the iPhone, Palm devices, BlackBerry devices, Windows Mobile and Pocket PC. The database currently has more than 1,600 listings! I have an iPhone and a Palm TX, and the application works flawlessly on both platforms.

When you’ll need it

Let’s say you’re a nurse in a busy ER. The triage nurse has just brought back the umpteenth patient to your care area and says, “The patient tells me she has a history of Naxos disease.” Of course, unless you grew up on the island of Naxos, you likely have no idea what this is or what potential it may have for your patient.

So you pull out your iPhone (or other applicable device), tap on the “Eponyms” application icon, type in “N-A-X-O-S” and quickly discover that Naxos disease is a syndrome that includes arrhythmogenic right ventricular cardiomyopathy. Within a few seconds you at least have a better understanding of a disease you had never heard of before.

You may customize the application by “starring” your favorite eponyms for quick recall. In addition, the application may be searched by category and covers all common areas of medicine: Anatomy, Biochemistry & Metabolism, Cardiovascular, Dermatology, Ear-Nose-Throat, Endocrinology, Gastroenterology, Geographical, Gynecology, Hematology, Infectious Disease, Miscellaneous, Neurology, Obstetrics, Oncology, Ophthalmology, Orthopedics, Pathology, Pediatrics, Procedures & Tests, Psychiatry, Pulmonary, Radiology, Renal, Rheumatology, Signs, Syndromes and Urology. A very comprehensive collection!

A special bonus: The “learn” mode on the iPhone allows you to shake the phone to display a random eponym or a definition. Quiz time!

Deals for students

Dr. Yee is currently affiliated with the Oncology staff at Massachusetts General Hospital and is an instructor at Harvard Medical School. He frequently updates his database and his prices are very reasonable. If you’re a student, the application for the iPhone is free. If not, it costs only $2.00 for the professional version. An amazing price for a very comprehensive database. There’s no difference between the two versions—Dr. Yee just seems to have a soft spot for poor students.

For more information, visit eponyms.net.

Image: © Veer Incorporated

I’m an Acute Care Nurse Practitioner for two busy community emergency departments in central Indiana. I’m also a paramedic with a critical-care transport ambulance service. Having been involved with emergency and pre-hospital care since 1982, I’m convinced that every nurse needs to carry handheld technology.

And if you print out this article and share it at your workplace, your boss might be convinced, too.

So why did I start using handheld technology? Why do I frequently share my experiences with colleagues (physicians, nurse practitioners, nurses, paramedics)? Why do I think all healthcare providers should have the ability to use these devices?

Answer: The wealth of information that handheld technology provides, no matter where your patient encounter takes place, allows you to deliver care that is safer than relying on your memory or an outdated print resource.

And without further ado, what is my recommendation for the best smartphone for nurses? The iPhone. I began using handheld technology in 1999 when Palm, Inc. introduced the Palm V electronic personal digital assistant (PDA). Although my handheld device of choice has evolved over time, I still have a very strong place in my heart for the ease and simplicity of Palm products and I still have a trusty Palm T|X at my disposal. But in the last year I have been making the migration to the Apple iPhone. The reason I choose the iPhone is because it incorporates a very intuitive operating platform for applications that assist me in my career as an ACNP with an incredible smartphone. One device does almost everything I want it to do. And here is the Scrubs Magazine list of the top 10 iPhone apps for nurses.

Each month I’ll review one or two software applications used on handheld devices, and share with you how these applications have made my job easier and perhaps safer for the patients I care for. These are applications that I actually use on a daily basis.

Stay tuned for my first application review: the Eponyms app (available for iPhone, Palm, BlackBerry, Windows Mobile and Pocket PC), a handy database of, well, eponyms!

This is my first article for Scrubs, and I look forward to sharing many more technology tips with you. My colleague, Andrew Craig, and I hope to share our experiences with you regarding point-of-care technology and how it may benefit you: the busy clinical nurse. Be sure to check out Andrew Craig’s take on the best smartphone for nurses and the best PDAs and apps for nurses.