Tutor: Joanne DeForest
Power as defined by Kelly & Crawford (2008) is the ability to achieve one’s goals by creating, acquiring and using resources to do so. Nurses over time - whether learned, cultural or related to gender-specific characteristics, have not embraced power (Kelly & Crawford, 2008). The public view of nurses as subordinates to physicians, simply “trained” to follow doctors’ orders, an overall lack of understanding as to the level of education and the kind of work nurses actually do (Sullivan, 2004) has lent to this perception. Sullivan (2004) writes about telling nursing’s story as an avenue to turn opinions around; empower nurses at an individual level, and ultimately raise the bar to a degree where nursing as a whole takes a stance to being viewed and treated as experts in the health care arena alongside other disciplines.
Nurses outnumber all other health care providers (Kelly & Crawford, 2008, p.6) in both acute care and community care settings; are the most diverse clinicians having knowledge and experience that intertwines with all other health professionals, the public and now the business world. Nurses collectively have a deeper understanding of the everyday goings-on within all areas of healthcare. The challenge is to convince those who do not recognize this attribute to tap into an invaluable resource. The message I have chosen to include in this paper will attempt to encourage and support the utilization of nurses in the area of clinical informatics, as this is an up-and-coming opportunity to recruit the experts.
Deciding on My Message
I have always had an interest in computers long before I went into nursing. As a new graduate nurse in the early 1990’s I went straight to San Antonio, Texas where at one of the hospitals I worked implemented a cutting-edge clinical documentation application in the intensive care units. I quickly became a champion user as I was quite comfortable with the whole concept. That, blended with my diverse clinical experience in nursing to include using many other applications in various areas set the stage for my area of expertise; clinical informatics. As a practitioner, I felt unfulfilled at the bedside, frustrated with the lack of positive recognition toward the profession, regardless of the root cause. Being able to move away from direct patient care to a role that required a strong clinical background, informatics became my passion.
My concern has intensified over the lack of clinicians called upon to do what nurses do best: clinical workflow analysis, agents of clinical change management and clinical adoption, and most important ensuring the application is robust enough for that program, clinic or unit based on expertise in that area. The further I observe resistance to change and poor adoption by nursing the more incensed I become with the lack of expert utilization. The motives for the resistance are significant: the omission of the nursing process, the inability to enter orders (physician and nursing), track medication and document medication administration is to list a few. These gaps could have been identified and possibly avoided had nurses been involved in the initial requirements gathering. Nurses understand process and know what questions to ask, as opposed to non-clinical analysts, who could not know what they do not know; who better to understand specific practice methodology and process than those who live it? Furthermore, physicians are viewed as the key holders to patient care while nursing and other allied health groups are seen as simply assisting the physician, not as part of an integrated multidisciplinary team. Nurses understand and embrace this model far more than other disciplines and are the best choice in this domain.
Deciding on How to Share My...