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Amazing Nurse Story

Posted on December 5, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Nurses are amazing and they are often the unsung heroes of healthcare. When I think about the times I’ve spent in hospitals I have almost zero memories of the doctors, but I have a lot of great memories of the nurses.

I was reminded of this fact when reading this pretty untraditional nurse story that @rn_critcare shared. I wonder how many times healthcare IT developers think about these kinds of unique situations that nurses face. Ok, they aren’t all this large, but they are just as nuanced.

As told by @rn_critcare:
Today in my role as nurse I wore many hats. Let me tell you a story about how the day went… #NurseLife
#medtwitter

Came in this am to discover my pt from yesterday had imaging overnight that revealed catastrophic injuries, along with her sepsis and multi-system organ failure

Within 1/2 hr her fiance approached me about calling in a chaplain, which I assume is to do final prayers. He informs me that he wants to marry her. Today.

I’m not sure b/c pt is sedated and fully ventilated, with no hope of waking up.

Spend next few hours calling chaplains/priests/ministers. Keep in mind it’s Sunday AM and church is happening soon.

I find out that if we can show “intent to marry” that a ceremony can be performed. Photos of pt trying on dress are used. A minister agrees to come after church.

Preparations are being made. Family is happy that we can do this for their loved ones.

Except Pt starts to deteriorate. Cushing triad. Call family in and discuss options. They have a family member willing to perform ceremony, if only for symbolic reasons now…

Hair is washed and braided. I give the sisters some sheets and scissors for a makeshift wedding dress (new) while I go collect flowers from other rooms around the unit. (borrowed)

Flowers are placed in braids along with headband & veil. A blue blanket is draped at end of bed.
Everyone lines up outside the unit and begin the parade into the room. So. Many. People. Can hardly make my way around but secure a post at the med pumps and monitor.

Music is being played, someone has a guitar and another has a drum.

The chaplains words are brief but loving. Asks him does he take her… I do. Asks does she take him, bridesmaids all reply “she does”

Everyone in tears

They are now all in song with only the drum being played, which I feel is shaking my entire soul
Everyone singing Stand by Me and I’m in tears.

Pt stabilizes somewhat. I realize it’s now afternoon and I haven’t had a break or worse, my coffee! I decide to step away for a few minutes. Go outside for air. Find myself at grocery store across the street…

Purchase cake and have 2 hearts drawn with their initials, some bubbly (sparkling juice), and plastic champagne flutes. There was a wedding after all… New groom takes bottle outside with fam, pops the cork & comes back for mini reception.

So much love

I decide to get some charting done. Post-op comes back across the hall and I’m called to help. CRRT machine beeping next door and tend to that. Realize I still haven’t eaten. Grab a cookie from the desk (weekend tradition from consultants)

Pt begins to fail again.

Family called back in, this time the air has changed. It’s heavier and somehow feels hotter than hours before.

The guitar is being played and everyone is singing Amazing Grace. Am I singing along? Maybe. Not sure with this lump in my throat.

Have to turn away and pretend like I’m tending to something very important, which turns out is the wall, but it’s holding me up now, and the singing and drumming is getting louder and I’m just trying to keep it together, keep her comfortable… Won’t be long now…

Her children are at her side now telling her they love her, how wonderful she is, how much they love their step-dad, don’t worry they will take care of him.

A tear falls down her cheek and now everyone is sobbing. My sobs are internalized and I keep my eye on the monitor…

New groom is by her side and I whisper in his ear that she has passed, as this sacred news is shared with a spouse first.

The new groom is now a widow.

One by one the people exit the room, each one reaching out for a hug. Each hug brings me a little closer to the inevitable spill over of tears. My heart aches for them. There are no words, my eyes pleading with them to accept my sincerest condolences…

They need help with funeral home. Explain of course I can help guide them, this is unchartered territory and I do this all the time. My insides are screaming ALL THE TIME!

Call funeral home, with request to leave braids untouched… Veil and flowers too.

I finish my charting. Realize there’s no supper break happening either. Wash my pt up. Gently remove the countless tubes and IVs. Use hushed tones as I explain to her what I am doing, because even in death we deliver honour and dignity.

Take a new nurse down to morgue with me, because it’s a teaching hospital after all. Carry on chatting as though my spirit isn’t weeping inside.
Get back to unit.

Take a long overdue drink of water.

No time for tears.

There’s an admission on the way.

#nurselife

Nurses Have Love-Hate Relationship With EMRs

Posted on September 26, 2016 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Data collected by a nursing degree program suggests that nurses have a love-hate relationship with EMRs, one which acknowledges many flaws but also suggests some degree of satisfaction.

The data, which was gathered by Adventist University of Health Sciences RN to BSN Online Program, offers a window into how nurses feel about hospital EMRs. And much of what they feel doesn’t reflect well on hospital EMRs.

For example, the graphic notes that in 2014, 92% of nurses were dissatisfied with EMR they had to use. Eighty-four percent said the EMR disrupted workflow and productivity, and 85% complained of “continually flawed” EMR systems. In other words, not only did they see their EMRs as flawed, they saw it as broken.

And these weren’t just vague expressions of discomfort. Ninety percent of nurses surveyed by the study said that EMR is negatively impacting interactions between nurses and patients, a fairly concerning claim. What’s more, 94% said that EMRs had failed to improve communication between nurses and doctors.

On top of everything else, a large percentage (88%) blamed high-ranking hospital administrators staff for selecting cheap systems. Isn’t it great to hear that EMR rollouts are alienating nurses as well as doctors? Just lovely.

On the other hand, surprisingly, 71% of nurses told a different study that they would not consider going back to paper-based medical records. Also, in other research, 72% agreed that EMRs help to improve patient safety and avoid medication errors, and 73% felt that EMR’s were enabling collaboration with other clinicians inside their organizations.

Looking at this collection of data, a few things stand out:

  • Generally speaking, nurses seem more comfortable with EMRs than physicians, more of whom seem to feel that EMR systems create obstacles to providing good care. But they’re frustrated nonetheless.
  • Too many nurses seem concerned that their EMR is glitchy technically. This should worry hospital administrators, because even if this perception is false, it’s a real problem if nurses believe that they can’t provide adequate care using the system.
  • Given that more than two-thirds of nurses responding to one study wouldn’t go back to paper, clearly some hospitals are doing things right (or at least paper was even worse than EHR).

Of course, nurses don’t develop ideas about EMRs in a vacuum. Hospitals can do a great deal to help nurses become comfortable with their new or upgraded EMR, such as enlisting the support of the chief nursing officer in any rollouts that take place and appointing nurses as EMR champions along with physicians. Not to mention ensuring appropriate training even after go-live.

Also, hospitals can do much to set appropriate expectations for EMR use. For example, I’d wager that few hospital IT leaders see EMRs as a particularly apt tool for supporting collaboration (though they might hope that it becomes so in the future). Being clear to nurses as to what they can realistically expect to do with an EMR — and what future features might be — makes it more likely that they’ll appreciate what the system can actually do. Like anybody else, if a nurse knows what they’re getting into with an EMR system, they are more likely to be on board.

Image Showing Tug of War Between Providers and Healthcare Execs

Posted on May 5, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

If you haven’t noticed I’ve been struck by images lately. We’ve done a lot of humor, but this image shared by Medfusion tells a very different story. Take a look.

Of course, I think this is just a stock image that they must have found. It really does illustrate well the tug of war that exists in many hospitals. I’m sure that those reading this blog know this tug of war all too well. There are exceptions where everyone is rowing together, but a lot of times the providers and the healthcare execs are pulling each other different directions.

In some ways this is good if there’s a good balance between the two. Both priorities are important. If the healthcare execs can’t run a good business, then the hospital will close up shop. That’s not good for anyone. If the doctors can’t ensure quality care to patients, then that’s bad for patients and business long term.

I think the girl in the scrubs that I think might be portraying a nurse doesn’t seem that into the battle. I think that’s true in many hospitals where the nurses aren’t listened to enough and so many of them stop fighting. It’s a pity since when I think of all my hospital visits, I think of the nurses.

I’m sure I could go on about this picture. It’s really well done. I wonder what it takes to get everyone pulling in the same direction?

7 Tips to Increase Nurse Adoption of Point of Care Technologies

Posted on May 1, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Over on the Point of Care Corner blog is a really great post about the 7 tips to get nurses to adopt point of care technologies. The post is really great because it comes from a nurse named Brittney Wilson (better known as The Nerdy Nurse). I always love seeing first hand suggestions from nurses and doctors and this list does not disappoint.

Here are the 7 tips that Brittney provides:

  1. Demonstrate Value
  2. Provide Ample Training
  3. Show Compassion
  4. Put the Patient First
  5. Feed Them
  6. Designate Super Users
  7. Ask for Input

The thing that stands out most to me in this list is showing compassion because it plays a role in every other tip. It’s amazing how making someone feel like you care effects someone. Show them that you care what they think of the change. Help them understand that you care how they’re being effected by the change. Listen to what they have to say before you respond too quickly.

Listening is an incredibly valuable thing to do when implementing any change in health IT. This is particularly true with point of care technologies where the nurse will literally live with the technology her entire shift. By listening to the nurses, you show you care, but they will also surprise you with valuable information you probably wouldn’t otherwise learn.

My favorite item on the list might be “Feed Them.” Even this suggestion is a form of showing compassion. Never underestimate the power of food (this applies to your IT support staff as well). I’ve always considered free food like a small raise. Not only did I not have to buy lunch, but I didn’t have to think about what I wanted for lunch either. Plus, the food becomes a social rallying point where everyone can discuss the challenges of the implementation and solutions they’ve found. In a bad implementation, sometimes just realizing you get some nice free food can make a terrible day not so bad.

Resistance to change is a real and powerful force in healthcare. I think these two cartoons sum up the challenge of change:
Resistance to Change Quote

This second one may take a minute to process.
Resistance to Change Square Wheels

The quality of the idea matters, but how you present and implement the change matters much more. Otherwise people will keep pulling the wagon with square wheels despite having a better solution at their fingertips. The best leaders realize this and make sure to incorporate compassion into the change process.

Are there other lessons you’ve learned implementing point of care technologies in your organization? Where have you found resistance to change in your health IT projects? What tricks and tips do you have to help those working through the challenge of changing something?

Nurses And PAs Use Digital Resources More Than Docs

Posted on September 5, 2012 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Generally speaking, the push toward EMRs is designed to change how doctors use digital resources and structure how they interact with other professionals. As it turns out, though, there may be more enculturation to do. Nurses and advanced practice nurses currently spend a lot more time using digital resources than doctors do, according to a study by market research firm Manhattan Research.

To conduct its study, Manhattan Research reached out to 1,1012 U.S. practicing nurses and physician assistants online during the second quarter of 2012. The researchers found that there were distinct differences in the way doctors and nurses used digital resources.

For example, the research group found that 74 percent of PAs, 67 percent of RNs and 60 percent of APRNs use smartphones at the point of care, as opposed to 40 percent of physicians.

Nurses are also bigger professional users of online resources than doctors. Researchers found that while RNs spend 16 hours online per week on professional activities, APRNs 14 hours and PAs 14 hours, physicians average 11 hours.

A particularly interesting stat dug up by Manhattan was that physicians were far less likely to be interested in using pharma features within EMRs. The survey found that 83 percent of PAs, 79 percent of RNs and 76 percent of  of APRNs were interested, but only 67 percent of physicians.

I’m not suggesting that Manhattan did its work badly, but I am surprised by what I see here.  If nothing else, study after study has concluded that doctors are avid users of mobile technology at the point of care, including both smartphones and tablets.

Of course, doctors and nurses have different workflows, and that alone could be enough to explain the different between their digital consumption habits and doctors’.  But I can’t envision quite as easily why doctors and advanced practice nurses differ so much. It’ll be interesting to see if doctors catch up over the next year or two.