The timing of this assignment was great because I spent 3 hours in training on both Thursday 12/8, and Friday 12/9. with an Informaticist from my new facility. She is not actually a Nurse Informaticist but has a behavioral health background (I believe she was an LCPC) and works in informatics for Maine Behavioral Health (my new employer). She explained that she works as part of a team that includes another Informaticist with a behavioral health background and two Nurse Informaticists (who work for Maine Health, our parent entity).
Since our assignment asks us to describe how the Informaticist interacts with others in the facility, and my experience in my new facility is limited to this past week of training, I will focus on what I experienced during my training sessions Thursday and Friday.
The Informaticist was extremely helpful and enthusiastic. She gave an overview of what Informatics was and was happy to hear I was in a class learning about Informatics. She gave very professional training on how to use Epic (our EHR) and especially focused on treatment planning.
Our assignment asks us for suggestions for improvement. What I believe could be improved is this: I sat through a total of about 6 hours of training. While it gave me an introduction to the system, it was based on a type of hypothetical office visit that I will absolutely not be doing in my role. While I took notes and retained some of the training in memory, much of the training would be hard for me to recall and utilize. And this is because it was not meaningful to what I will be doing.
My suggestion for improvement is that the EHR training comes along with the actual point of care. In other words, I think the training would be more effective if new nurses were shown how to utilize the system to care for the patient based on the actual caring tasks they will do for the patient.
McGonigle and Mastrian (2022) discuss the caring theory of Jean Watson and how the nursing actions we take to help our patients achieve better outcomes are part of a process of one human being caring for another on a deep person-to-person level. The authors discuss the importance of putting the patient first and focusing on the care of their patient rather than having the patient feel like the nurse is more engaged with the technology than they are with the patient.
I believe that an approach to learning the EHR that has a focus on what caring behaviors will come first (and then how we use the EHR to help the patient, would be more meaningful training for a nurse that is new to the facility, as compared to just showing all the bells and whistles of the EHR separate from a real patient encounter. Mosier et al. (2019) discuss the importance of having nurse input in the development of informatics processes since the nurse will have a greater idea of what the actual tasks to be completed would look like. The training I got was based on a type of office visit that I will most likely never engage in during the course of my present role. It just feels like if I were to go ahead and train right in my role, along with a superuser of the EHR to guide my use, the training would be more relevant. This is validated by Shala et al. (2021), who discuss the benefit of ongoing training and what they refer to as “at the elbow support”(Shala et al., 2021) for nurses learning an EHR.
For a specific example of what I envision: My new role is to help people medically detox from alcohol in a level 2 partial hospitalization program. Even though my facility has not yet decided on a specific workflow, from my own experience, the process is pretty straightforward. The patient will come to us from the ER. They will probably have been medically stabilized there with a dose of Librium or some other benzodiazepine. I will take vitals, I will utilize the CIWA scale (Clinical Institute Withdrawal Assessment for alcohol, which a standard assessment tool to be done for a person withdrawing from alcohol) to assess the patient. I will complete a medication review and probably pull a prescription monitoring report. And then write it up, including the provider’s response to all this data when I share it with them. It would be great to have a superuser show me how to utilize the system to record things as I do them.
Jordan (2008) discusses information technology as being in a constant state of change and growth. In accordance with that assessment, it is probable that Nursing informatics and technology will continue to evolve and become more complex. There could even become more specialized areas of nursing informatics, where an Informaticist focuses more on a specific area of nursing. In my own facility, there are now Nurse Informaticists and Behavioral Health Informaticists. What is obvious is that nurses need to be prepared to interact with Nurse Informaticists and even cohorts who may be more solidly on the IT side of things (not a nurse but still an IT part of the team). To help our patients, we need to be able to communicate our needs and to ask for help in implementing solutions. In order to do this, we need to be more educated about technology and advances. Sipes (2016) discusses the importance of fully educating nurses to be competent in informatics, so they can fully engage in patient care, utilizing all these great technological developments. Tiase (2022) discusses the future role of the nurse and how the overall promotion of health equity is solidly in the domain of nursing. Tiase (2022) also discusses social determinants of health and how important Nursing Informatics as far as working with and creating data that can help us all navigate these social determinants of health for a better future for everyone. Tiase (2022) also stresses the importance of nurse competency in this area and the responsibilities nurses have to be educated in Informatics and technology to be a productive part of the future workforce.
References
Jordan, A. G. (2008). Frontiers of research and future directions in information and
communication technology. Technology in Society, 30(3), 388–396.
https://doi.org/10.1016/j.techsoc.2008.05.002Links to an external site.
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of
knowledge (5th ed.). Jones & Bartlett Learning.
Mosier, S., Roberts, W. D., & Englebright, J. (2019). A Systems-Level Method for Developing
Nursing Informatics Solutions: The Role of Executive Leadership. JONA: The Journal of
Nursing Administration, 49(11), 543-548.
Shala, D. R., Jones, A., Alexander, N., Young, S., & Fairbrother, G. (2021). Responding to the
Challenge of a Pandemic: The Rapid Conversion of Electronic Medical Record Training for
Nurses From Classroom-Based Instructional Learning to a Blended Learning Approach in a
Large Multisite Organization. Computers, Informatics, Nursing : CIN, 39(4), 171–175.
https://doi.org/10.1097/CIN.0000000000000735Links to an external site.
Sipes, C. (2016). Project management: Essential skill of nurse informaticists. Studies in Health
Technology and Informatics, 225, 252-256.
Tiase, V. L. (2022). The Future of Nursing 2030: Informatics Implications. Computers,
Informatics, Nursing : CIN, 40(4), 228–229. https://doi.org/10.1097/CIN.0000000000000923
