Book Review: The Nerdy Nurse's Guide to Technology

I read Brittney Wilson’s book The Nerdy Nurse’s Guide to Technology last night (Amazon paperback link here, ~US$33; Kindle link, amusingly glaringly mistitled The Nerdy Nurse's Guide To Using Technology, here, ~US$35; why the Kindle edition costs more and why people pay for either, I don't know) and subsequently posted a negative review on Amazon. Before that, I’d watched The Nursing Show’s video podcast interviewing her about the book. She and I have butted heads before, mostly over the Amanda Trujillo smudge on our profession, and we eventually buried the hatchet over that, although we fundamentally disagree about some things, enough so that I’m stating up front that this is not an objective review. I hope it still receives due consideration.

I have never met Brittney nor spoken with her. Our e-mail exchanges have ranged from hostile to merely fact-finding, and I commend her both for stating publicly when she is wrong and learning from her behavior and for applying butt to chair and finishing a book. Neither of those things is easy, and both deserve respect. I bear her no personal ill will. I do, however, harbor professional concerns (both of my professions: as nurse and as editor) about her “branding,” as I believe she calls it.

The book

Credentialing and legitimacy concerns

Brittney calls herself an “informatics nurse.” Brittney is not an informatics nurse. What she calls “informatics” is really “tech support.” I’ve read and reviewed real books on nursing informatics, and the field emphasizes information science, of which she has zero evidenced knowledge. Nursing informatics involves extremely complicated knowledge of database architecture and use combined with hardware and security needs. Most nurse informaticists pursue graduate-level education in computer or information science. They do not spend time writing technical how-to manuals on Google Docs and how to buy a laptop. This mislabeling is as serious as a CNA calling herself a “nurse” and amounts to nothing less than deception.

The only topic in the book related to nursing informatics is her discussion of meaningful use, and the discussion is badly organized and scattered throughout the text. Appallingly, she uses Wikipedia to cite these issues actually at the core of informatics, and although I love Wikipedia as much as the next person, it is not appropriate as a source for any “expert” published material. The extensive Wikipedia quoting on the area an informaticist should know is pathognomonic of her ignorance of the material.

The other major issue with the “informatics nurse” label is her attempt to pose as a serious informatics professional while maintaining a bouncy, friendly tone. The result is jarring to the reader. For example, she writes, “As a nurse, you can access any information you may need to help you educate a patient or perform a procedure (except experience, of course—only time can give you that!).” The following example is www.lolcats.com, rather than a more relevant example of educating patients or accessing information by using technology, per the stated goal of the book.

The legitimacy of the information in this book as a whole is questionable not only because Brittney is not an informaticist, but also because it is published by a society, meaning nothing is peer-reviewed or likely to be reviewed by an expert. There is no reason a book like this should be peer-reviewed, but in effect Brittney is the expert reviewing her own book, and the results are disastrous.

Finally, I question basic contradictions not just in the book, but in her stated nursing and blogging philosophies. Brittney got hazed as a new nurse and turned to blogging and Twitter for help. Presumably, she had to describe the problems. But she disparages other bloggers who discuss negative situations and other nurses who say negative things about coworkers. I present for consideration the following quotations from the book:

“I’ve known several nurses in my day who have lost all passion. They do their nursing tasks and complete routines, but their hearts are no longer in the job. An informatics nursing friend of mine calls them “Appliance Nurses”—nurses who are only working so they can afford their next major appliance. It’s unfortunate, but these dinosaurs stomp around and take up space, warm chairs, and refuse to give more than the bare minimum.”

You lose your moral high ground in judging other bloggers when you say things like your coworkers are just taking up space and warming chairs, methinks.

“I’ve read many nursing blogs whose authors include a great deal of profanity and talk negatively about their patients and other nurses.”

Kind of like referring to coworkers as dinosaurs?

“If you’re a nurse who has ever felt bullied or even just ignored, Twitter can be an outlet like no other. You can discuss your frustrations with current nursing issues that you see every day.”

Except if you do, hypocrites like Brittney will take exception to it. Hypocrisy is a strong term, but these examples can lead to no other label.

The editor in me flinches

Brittney doesn’t like “grammar trolls” and writes defensively about her issues therewith:

If you happen to write a nursing blog, then no doubt the grammar and spelling police will be sure to let you know of any mistakes you’ve made. I’ve written several well-received articles that have had the grammar trolls out in full force. They have publicly (and sometimes anonymously) attacked my professionalism and my intelligence all over a misused word.

I’m pretty sure I’m one of the grammar trolls to which she refers. A message can have merit regardless of its delivery: misspelled, wrapped in profanity, or badly explained. Still, I strongly believe that consistent and blatant errors show carelessness and cast doubt on the writer’s credibility, and the seriousness of the doubt increases dramatically when the errors appear in an expensive “published” book (scare quotes because the publisher is Sigma Theta Tau International, and that makes this basically self-published).

The following examples appear in this book. Can anyone take a book seriously when it is filled with such errors? Can anyone take the word of a purveyor of the utility of technology who cannot use spellcheck?

  • “Another nurse I know has a serious of ebooks that she has written on topics that appeal to nursing students and new nurses.”
  • “…many patients may use WebMD in an effort to diagnosis themselves….”
  • “Because the hardware is more propriety, make sure that any additional hardware (printers, extra memory, protable storage) that you buy for your Mac computer has been Apple approved.”
  • Worst of all, she writes, “…people do spell things incorrectly on the Internet.” Like “Bollean,” immediately following, in a blurb which does a great job of describing wildcards in searches but has absolutely nothing to do with actual Boolean searches (which even a fledgling informaticist should know about).

Obvious errors and typos aside, the entire book is filled with exclamation points, as, curiously, are the shining reviews on Amazon. Granted, this is a stylistic choice, but it is an unprofessional and overly casual one, and I found the book increasingly grating to read with all that enthusiasm. Indeed, not far into the introductory material, I felt strongly as if I were reading a very rough draft and not a finished product. The introduction immediately veered off course by a tangent on the importance of reading dialogue boxes, and this set the tone for the book. Namely, Brittney does make good points, but they are randomly scattered throughout the text and given strange weight (e.g., why do we need an entire paragraph on this really specific dialogue box topic plunked into the introductory material?).

The writing tone instantly struck me as patronizing, and my opinion never got better as I read on. She immediately errs in selecting a second-person viewpoint and using it to establish a they/you dichotomy, as in “[t]hese clinical professionals are working behind the scenes to help you deliver good patient care.” (We, the knowledgeable informaticists, are trying to help you, the technology-ignorant serf.) Lest I seem overly harsh with this criticism, consider the following example of the kind of chiding, scolding tone espoused by “[c]losing the box without even reading it is not the correct response.”

Link baiting and money

Being paid to have opinions is the major issue Brittney and I will probably never agree on. I don’t think it’s right. Being paid to write is one thing, but being paid to push someone else’s agenda is another, and although it does not have to be dishonest, I just personally don’t like or agree with it. I especially don’t like the manner in which Brittney pushes her personal branding and sponsors’ agendas constantly. It feels cheap. She left a comment on a blog that pays me for contributions, for example, but the only purpose of the comment was clearly to leave a link for Scrubs Magazine, which pays her to laud it at every opportunity. (I flagged it for the spam it was.) In every forum I have seen her, she is very obviously slanting her voice toward the highest bidder. Again, I do not categorically think that making money is wrong or that making money from advertisers is wrong; I just abhor the way she does it. I am trying to be less crass lately, but her practices truly exemplify the meaning of link whoring.

This book is no different. It costs way too much, to begin with, although that isn’t Brittney’s fault. It heavily leans toward certain products and services, and with her I have to wonder whether that is because she thinks they are actually better or whether she’s being paid to say so. This shows the crux of my objection to her branding approach, and I go back and forth as to whether it’s actually unethical or just personally objectionable.

With clueless irony, she writes “I actually created a forum post…on allnurses.com and was quickly told by a forum moderator that if I wanted to advertise, I should purchase advertising. This quick reaction really put a foul taste in my mouth….” I bet it did. I get that same taste almost every time I read something she writes and had it when she left a comment on my blog to drop link bait.

Again: “[t]here is nothing worse than searching for information and being directed to a super spammy website whose primary goal is for you to click on an advertisement. This does nothing to improve the Internet and in general is a huge pain.” She wrote that, not me, but I totally agree with it and am baffled as to how she can write such a thing given that her own site is a “super spammy website” and that most of what she writes anywhere has the primary goal of advertising.

Unexplained choices

The book is heavily Google and Windows based. Google and Microsoft make the world go round:

Google, for example, has a multitude of web apps, a browser, and even an operating system (OS). Microsoft, which owns the search engine Bing, is the creator of Windows, Office, and many other products we know and love.

I know of no real nerds who love Windows or Microsoft. That is why God made Open Office. Anyway, she glosses over Apple products except for iOS, mentioning, in the nerd version of a car salesperson showing a female buyer the makeup mirror first, only that Apple hardware is pretty and makes her feel that her laptop is clunky in comparison. I can see why, because statements such as the following show that she lacks even rudimentary knowledge of Apple computers (even a tech-support nurse should know this stuff, much less an informatics nurse): “Because the hardware is more propriety [sic], make sure that any additional hardware (printers, extra memory, protable [sic] storage) that you buy for your Mac computer has been Apple approved.” Is there an Apple imprimatur I’m unaware of? The biggest issue she found for switchers was the lack of a right mouse button, so that shows some deep reflection and investigation.

From reading this book, you’d think that Google is the only player. I seriously wondered if she was getting kickbacks for recommending Google and, specifically, the Chrome browser. With her, that is a legitimate question. Evidently, she has never even heard of Safari and strongly implies that Chrome is the only browser that works: “If you also take into consideration that Google Docs will take care of your word-processing needs, there is really no reason to use any other web browser.”

Finally, she manages to bash nightshift and tout Google in one blow: “If you work the nightshift and have hours of downtime, a Chromebook could help you pass that time.” Maybe tech-support nurses have hours of downtime on nightshift, but the rest of us don’t.

Redeeming value

This book has a smattering of useful information. Brittney keeps an emphasis on safety and common sense regarding HIPAA and HR, and she writes appropriate warnings about blogging safety and transparency. There is no “enough” for these topics. Most of us, even veteran nurse bloggers, still make mistakes and learn, no matter how long we keep at it.

Brittney also presents some basic use cases that people may not have thought of, such as using “Google Form” (although it’s actually “Forms”) on a blog. Her discussion of free alternatives to Office may be a lifesaver for people who are enslaved to Microsoft Word, even if her discussion centers on Google Docs and not other equally deserving software. Finally, she does an admirable job of explaining differences among social media platforms. This is not an easy task, and the things have a tendency to sprout like mushrooms and incestuously combine. Her summary is good for people who are totally new to the scene.

Summary

This book is a mitigated disaster (“mitigated” by the redeeming values above). I feel as if I need to justify why I spent the time to read the thing and then write such a long and negative review. As for reading it and writing a long review, I simply have time to do things like that right now in my life. As for the negative part, I hope I have been articulate enough throughout to explain why I think my points are important to nurse authors and bloggers. I hear and read only glowing reviews, and perhaps I’ve tried to counterweight all of that. Finally, I do not have a personal grudge against Brittney, although I can certainly see how this seems personal and bitter. I just disagree with her.