I had developed MacNursing between 1985 and 1994. I supported it at Saint Francis over a period of approximately ten years. I had sold a copy to Saint Luke’s psychiatric unit, a psychiatric unit in Georgia and the spinal cord injury center at the Veteran’s Hospital in Palo Alto. Everybody loved the program as it was focused on the nursing process and was so customizable to any nursing unit’s paper work, including care plans. Re-admissions were fast because the patients information was kept in a database. This was a fairly new concept in the eighties. Most hospital computer systems up until that time were primarily for billing purposes. My program was one of the first, if not the first, computer programs where the entire admission process was done on a personal computer or Macintosh. Of course, in 1982, I had started writing the program on a Macintosh, using “4th Dimension,” by a company called ACIUS.
Over the years I had become fairly proficient at Hypercard, Filemaker and 4th Dimension. I enjoyed creating databases and after I left Saint Francis, I continued supporting the network of about 10 computers at the V.A. Eventually, the V.A. system wanted to shut down my program and replace it with something more universal to the entire V.A. system. Elaine Lloyd had indicated at one time that my program might be expanded to other V.A. spinal cord units but that never came to pass. It just wasn’t meant to be.
At that point, I had pretty much lost interest in MacNursing. I wasn’t making any real money from it. I had not real business skills, marketing skills or public speaking skills. I could have benefitted from a partner but I didn’t know how to find one.
Since I was no longer supporting MacNursing™, I was not doing any programming. I had ideas for a 4th Dimension server system where the end user’s data would remain local but the database structure would be remote. At that time, in Vallejo, I didn’t have access to a fast internet connection. I lost interest in that.
I spent hours developing a Care Planning cd that I started selling from a new website I had created called, “Nursing Desk Software.” Essentially, it was the care planning aspect of MacNursing minus all of the patient admission
paperwork. It was for the purpose of assisting nurses or nursing students in the time consuming process of writing care plans. I also offered a few continuing ed classes on my website which no one every took. There was a steady trek to the post office to mail a cd here or there but, again, it was just never a money making proposition.
Here are the instructions that came with my “Care Plan Generator.”
When the main screen for the program opens, you can get additional help while using the program by clicking on Help and selecting Show Balloons.
Note that the top part of the control panel is for writing nursing problems and the bottom half is for writing care plans. A definition is provided on the screen for each.
You will see a list like this if you click the first button in the top half of the control panel that is labeled “See List of Problems that you can ed, print and delete.”
If you click Print Selection, all the nursing problems in the list will be printed. You will have an opportunity to cancel printing if you change your mind.
If you double click a problem, you will see the next screen shown below.
NOTE: once you are in this screen or any screen other than the main screen, you can not use the pull-down menus until you click “Done” and return to the main screen.
On the Problem detail screen you can edit problems or “mark” problems for printing. The row of navigation buttons at the bottom of the screen take you through the problems. The first button takes you to the first problem in the list. The next two are backward and forward buttons. The next button takes you to the last problem in the the list. The trash button will permanently delete a problem from the Care Plan Designer. If you edit problems, clicking on Save will save your changes. Cancel will cancel your changes.
To exit this screen and return to the list of problems, click either save or cancel.
From the list, click “Done” to return to the main screen.
From the main screen, if you click Write a New Problem, you will come back to a screen like this in which you will add your problem.
From the main screen, if you click the button “Search for Problem(s) to Edit, Print or Delete,” you will get the search editor. Usually you will click Problem Name in the first column. “Contains” is the best choice from the second column. Then type in your criteria in the “Value” space. See the example below.
Problem Name was selected from the first column. Contains was selected from the second column. Hallucination was typed in for the Value. Then OK was clicked on. You can save search parameters and load them later. Click Cancel to cancel a search and return to main screen. Click OK to continue with search.
Care plans are handled in the lower part of the main screen. Care Plans consist of groups of problems you have assigned to specific patients and then edited and individualized to those patients specific needs.
From the main screen click the button “Click here to see a list of care plans you can edit, print or delete.”
Double click a patient chart to see the care plan for that patient
Here you see the care plan for John Doe. One problem has been entered. From this screen, you can edit a problem without changing the master problem in the problem file. Any changes made on this page are only for this specific patient so you can individualize the problems.
To enter a new problem, double click in a blank problem space.
Double clicking a blank problem are will take you to this screen where you can select problems for your patient. Follow the directions on the screen.
NOTE: Do not edit problems or individualize to specific patient on this screen.
When you have finished entering problems, click Cancel to return to patient chart for editing.
Once you have returned to the chart page and have edited and individualized the patient care plan to you particular patient, save the care plan by clicking “Save.” Now you can print out the care plan for the patient or exit. Anytime you want to update or edit the care plan and reprint it, just click the “See List of Care Plans…” button on the main screen.
By the late nineties, care plan book publishers had started offering care planning software and at that point, it was impossible to compete. The rest of the world had caught up with what I had started back in 1985.
After that, when the iPhones came out, I did a little iOS programming just to see what it was about. I actually used a Hypercard like environment called LiveCode. I created several iOS apps and was excited that I was able to do so. I was a app developer for the iPhone. For about five minutes, anyway, lol! Actually, I probably spent six months or so playing with LiveCode, creating iPhone apps but then they kept “breaking” every time Apple would upgrade the OS and I would have to figure out what to fix. It was an ongoing task that became too burdensome very quickly and I lost interest.