Notes From A Nurse: Technology In Healthcare

5-1-2015 1-17-59 PMTechnology changes the world we live in on a daily basis. There is always a new gadget or gizmo coming out on the market that is supposed to save us time, make our lives easier, or benefit us in some way or another. The marketing is usually well-planned, and it targets people of all ages, not just the GenY and technologically savvy. It is also changing how we do healthcare.

The federal government mandated that all hospitals and physician’s offices across the country have some type of electronic medical record by the beginning of this year. The thinking is that it will help make things more standardized across the board, and will make the charting process more efficient. The goal is to make medical records containing history, allergies, diagnoses, medications, and treatments available to clinicians around the country quickly and easily.

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As a nurse, I work with electronic medical records every day. I have always had computerized charting, ever since I started as a new-graduate nurse. I never learned the art of paper charting, or how to read the infamously atrocious handwriting of doctors. All of my orders have been neatly typed, with little room for errors in interpretation. I have always had the ease of entering into the computer whatever treatments I’ve given to my patients, be that medications, physical assessments, or vital signs.

Most of the time that task has been as simple as selecting the correct treatment from a dropdown menu of choices. Sometimes I’ve had to add in notes in a free text box to explain what isn’t exactly covered by the dropdown selection. I now use a system where I don’t even need to use a mouse. All I have to do is tab, arrow, and enter to select the value I want to enter into the patient’s chart.

Sounds like a wonderful, high-tech solution to a problem, right? It is. And most of the time it is truly a marvelous thing! As a GenY-er, I quickly and easily adapt to the changing face of technology in the healthcare world like the rest of my generation. But not everyone does. And it’s not always all it is cracked up to be either.

Sometimes, older nurses have problems with the system, and it is much harder for them to navigate it. If they haven’t familiarized themselves with the basic functions of a computer, they have more trouble than their peers who have done so. I know such nurses; they do their jobs well, and their patients are always well taken care of. They’re old school, and I enjoy working with them quite a lot. They have a great deal of wisdom, and have seen things change drastically over the many years they have been doing what they do. But some of them struggle with the computerized part of their job.

Not only is it a problem for some of the more seasoned nurses who have been doing this for years, it can be a problem for the GenYers. Not in the same sense of course; our problems come when for one reason or another, the system is not functioning as it should, is completely down, or is being updated.

We all know our personal computers, phones, and tablets need to be updated from time to time. It’s annoying when your device informs you it needs to shut down in order to install an update that it thinks you need. Sometimes, until that update is done, you are left scrambling because you’ve become dependent upon that piece of technology.

Magnify that stress by 100. That is what it is like when the computer system of a major hospital or hospital system is down. Suddenly, those nurses like myself who have always had the ease of technology no longer have that comfort to fall back on. We have to chart on paper. We have to decipher the scribbling that is supposed to constitute a physician’s signature or order. We are totally and completely lost. For most of us, it can be one of the worst days in our career. If we have the ability to schedule ourselves for our weekly shifts, most of us will avoid working on days where there is a planned downtime of the system.

Not all of us are that lucky. This was the exact situation I found myself in this past weekend. I also became more grateful for those nurses who have been around for several years, those who knew what it was like before we became completely digitized. All of a sudden, I was a brand new nurse again who had no idea what to do. I couldn’t read my orders, and was constantly asking either the nurses around me or the doctors themselves what was written on the page.

It’s days like Sunday that make me question whether or not this electronic health record system is as efficient and valuable as it is said to be. Nursing is a science, but it is also an art. We are beginning to lose some of that art, especially as it relates to communication with doctors and each other.

Some days, technology makes my job easier, and some days it makes it more complicated. And isn’t that always the case when the law of unintended consequences is in effect?
By: Rachel Clark, RN, BSN