nursingforsocialjustice

I work in health informatics. It’s quite the emerging area for nurses. However, sometimes it seems like the knowledge base for clinical nurse informaticians is quite elusive. It is quite an interesting experience to be at the ground level of an area of healthcare that nurses are going to be emerging leafleting in. Sometimes, I wonder how we will get there without having experienced nurse informaticians well integrated in the system to be mentors and leaders. But then I think, this has been the forever journey of nursing and nurses.

I’m struggling with understanding this loss that nurses feel in the transition to EHR, about the loss of the patient’s story when what I think they mean is the loss of the nurse’s narrative of the patient during their hospital stay. I have been a nurse for 13 years. I do not know if I have ever worked in an inpatient program where the focus was not on the current inpatient stay. I think that it is curious, the way that we seem to romanticize something that we never had, but was an idea of what we could have had.

Think back. If you are a nurse, was there a time in your career when data like vital signs, fall assessments, pain assessments, ADLs were not captured on a flow sheet? A time when discrete data was not collected as part of an assessment and documented on a flow sheet? Think back again, think of a time when objective data wasn’t prioritized over subjective description by the patient about their experience. How was that information captured on the health record?

I would really love to do a retrospective chart analysis of one year pre and one year post EHR implementation on a mental health inpatient unit and find out what this loss of story is and why we miss it so much, and what the impact is on care. I wonder if nurses who were educated after the popularization of computers, smart phones, etc. feel the same sense of loss? Is it more about missing the connection to models of care less driven by efficiency and more by relationship building?

Peace,

Michelle D.