E-medical records – a complaint!
This nurse really needed to get something off her chest.
Do you share her frustrations?
I worked my first shift as a ward registered nurse yesterday on a busy surgical ward in a public hospital. When I finished my degree I decided I loved theatres and went straight into a scrub scout positon in a private hospital. Now, don’t get me wrong, I still love theatres, but I decided that to be the well rounded nurse I want to be I needed to gain experience as a ward registered nurse as well. So I applied and got a casual pool position at the same hospital I worked at as an undergraduate assistant in nursing. It felt like I was coming full circle and, in a way, coming home because I had received a lot of support and encouragement throughout my studies during my time there.
I’m stating the obvious by saying that theatres and the wards are like chalk and cheese, but the things I struggled with were not what I thought I would. It was not the patient load (because to be honest my first shift was supernumerary), medication rounds, S8s, the injections or the IV-giving sets singing me the song of their people or the fact I had miscalculated my measurements when ordering my uniform and looked like I was wearing a blue hessian sack with pockets. No, not even close.
The thing that got to me was the E-Medical records. Lauded by administrators at orientation and trainers during training as the one-stop-shop for access to patients’ clinical information and an advancement to help us provide better care. My first experience was anything but advancement – or even access for that matter. It has increased the workload for nursing staff fourfold. And that is just when the computer is not frozen.
This system has so obviously been pushed for and implemented by people who have never had to work a nursing shift in their life. Just to do observations and document them took the patience of a saint and when I had a sick patient who I feared was about to deteriorate, I couldn’t even look up her observations from the previous shift because the computer on wheels had frozen. What’s more, just to enter the baseline observations, including neurovascular observations, took a stupid amount of time due to the amount of clicks it took to just get a yes or no answer! Gone are the days when you can just flick open a folder and find the form you need.
I had alerts that were not pertinent to my patient, such as IV cannula assessments and urinary catheter assessments, as they were four days post-op and didn’t have a cannula or catheter. It was a waste of time to stand at a computer and click through on every patient that these things had been done like a child who was clicking off homework tasks. What’s more, some things were on the computer and some were still in paper form.
Honestly, this system has potential. But it needs a lot of ironing out and very genuine ongoing consultation with clinical staff who use it every day. Plus, every single bed should have a dedicated tablet or something, because having to write my observations and things in a notebook and transfer to a computer – when I could get one that worked or wasn’t occupied by someone else, also about to have a conniption about how slow and how un-user friendly it is – in between answering buzzers, medication rounds and while short staffed, was bombastic to say the least. And then when I did get one and get to put my information in, it was slow and froze halfway through what I was doing and I had to start again! The more people on them, the slower things were. In this ‘computer age’ that is a completely avoidable and unnecessary issue.
In the time it took me to document the observations of two patients, I could have done two whole four-bedded rooms in my AIN days. In its current format it is an accident waiting to happen. It saddens me to think that no one will listen to us until a deadly mistake does happen and then we will more than likely be the scapegoats.
Cartoon credit above: Working Nurse www.workingnurse.com