Tuesday, September 23, 2008


Over the past couple of weeks, one of the hospitals I routinely start cases at has completed their change to the electronic health record. It's been interesting to watch the nurses as they struggle with this conversion. I'm so glad that for now, it isn't me that's going through this. I have enough trouble without having to chart in real time.

The first night they initiated this, they had employees who were experts with special training with the new computers. They had fluorescent vests on that marked them for all the world to see as the super nurses (it's not like they had a choice-the way it works is your boss identifies you as the sacrificial lamb and next thing you know, you're an expert at managing EHR software and simultaneous staff meltdowns). Really, all these experts lacked was a hard hat and they'd have blended right in on any construction site. Since this time a couple of weeks ago, the uber nurses have graduated to purple t-shirts that say in big white print on the back "SUPER USER." Couldn't they have just been identified as such during report at change of shift-without having to be forced into a costume? It's not like their colleagues don't know their names.

The nurses are pulling their hair out trying to get used to this new way of charting. None of them are happy because they don't have the time to actually provide care for their patients; they're too busy providing care to the electronic, inanimate object. I'm guessing that the patients aren't happy either. Come to think of it, neither am I. I don't like to bug people for information that two weeks ago, was a quick chart perusal away.  I think they're busy enough without me adding to their workload. Unfortunately, though I'm a system wide employee, I don't have computer access to their EHR. If I want recent vital signs or medication sheets, I have to ask a human to access her computer to tell me. Now, if not everyone has the same access, tell me how does this improve the continuity in patient care? Really, it's all a bit ridiculous. I feel bad for my colleagues-especially when I have to bug them for information; it's not like they're not busy enough. I feel really bad for the ones who have to take a patient assignment AND wear the costumes. I have to remember to take them some chocolate the next time I go.

Next time you're laid up in a hospital bed waiting for your nurse to bring your pain meds, remember please that all of this and the lack of care was brought to you by some politician with ties to lobbyists. That's who you want to go all Shirley MacLaine on-not your nurse who has just slipped a disk trying to balance all she has to do in a shift.

Photo of Nurse Ratched courtesy of Google Images


Brenda said...

I really don't understand this at all. We have a new hospital not far from me, that I read in the paper is all electronic. There is even a computer information area, that sounds similar to the airport screens where you look for flights arriving and departing. Well, not that big, but still. I may go check this out one day if I have time, because I am curious. Do you have to stand in line to view the computer that has the information about what room a patient is in. Kinda Weird. Also, what happens to all of the info when the computer crashes. They have to spend a lot of time backing up all the files on another external drive? I went one time to a Dr. who carried his lap top in the room with him and not much else. His nurses did too. I think the prescription he gave me was also a print out from his laptop. Does that all sound possible or did I dream this? I recognized the nurse picture from One Flew Over The Cuckoo's Nest. Very Cleaver!

Mrs. G. said...

Nurse Ratched. Shiver.

laurie said...

the clinic i go to has a computer in every exam room, and the nurses just chart as we go. blood pressure...they type it in. pulse...they type it in.

i don't mind. but when i'm sitting there in my paper gown waiting for the doctor, i always have the urge (resisted so far) to log on and check my email.

The Rotten Correspondent said...

Ahh, yes. The electronic age. We're all electronic in our hospital and it's absolutely a mixed bag.

My personal favorite, in regards to your Terms of Endearment clip, is the med pyxis. When I do have someone going all Shirley McClaine on me for a pain med, or when someone has a heart rate of 20, why, oh why is that when the cart won't let me take the med until I count them all?

Do I have to count Zofran? Of course not. But those pesky circling the drain meds? Well, of course.

The Rotten Correspondent said...

and laurie,
you aren't the only one who thinks to check their email. But you need a password to log on in the rooms.

HIPAA, you know.

Sandy said...

This is very disturbing to me, why, because it worries me that once we are assigned a number for everything (well I guess we already are - SS#)...that the next step will be to implant us with a capsule that will hold all our info on it, regarding everything, every purchase, every illness, etc., and ....oh I just can't go there..gotta stop...

Rose said...

It's amazing how similar the pitfalls of nursing are to the pitfalls of teaching. I feel like I'm drowning in minutia (sp?) and yet I'm spending time reading blogs instead of catching up on my paperwork. Hmm, procrastination; wasn't that your topic yesterday? Maybe I'll write my blog now; that'll take at least another 30 minutes!! :)

The Crusty Crone said...

Oh I feel for ya. I feel for everyone. The change (manual/electronic charting) sounds like it/was a big one. It can be so frustrating during the learning curve where all the bumps and dents get smoothed out.

I hope things work out with time.