When I first became a nurse, one of my favorite questions to be asked was “What kind of nurse are you?” The fine print of this question, of course, is “where in the hospital do you work?” I would swell with pride and proudly state that I was an “ER” nurse.
As far as I was concerned (at that time) an ER nurse was the best kind of nurse anyone could be. Sure, working in the critical care area must have its challenges, but how hard is it to take care of an intubated patient who I had so kindly stabilized for you? As for the nurses on the floor, I mean, really? These patients were of the walkie-talkie population. Hang a few bags of IVs, push a little Lasix and remind your nurse tech to measure their output. Obviously nothing compares to the ER.
Fast forward many years to today and I have to tell you what an awakening I have had. After leaving the ER for a myriad of reasons, I crossed over to the dark-side of nursing … also affectionately known as “HIT”. It was during my years working as a clinical systems analyst that everything I thought I knew about med-surg floors made me realize that I had no concept of what it was to walk in their shoes and understand what their workflow was all about.
The nurses who worked on the med-surg unit were taking care of a complex, diverse group of patients with varying degrees of acuity; more times than not, without the assistance or extra set of helping hands of a patient care tech, because the patient care tech was in a room with a confused geriatric patient who couldn’t be left alone. I watched these nurses document on napkins, scrubs and sometimes bed sheets all while taking phone calls from different doctors and receiving orders. Additionally, they were working with social services, the hospice nurse and every other visitor who decided to stop them in the hall and ask about their loved ones. I remember thinking, who signs up for this gig? To say the least, I was humbled by their dedication.
The big picture of this is that “floor” nurses are the ones in need of technology to complement their workflow and not impede it. Technology should not be seen as “big brother” watching over their shoulders, but as an extra set of eyes to help them do what they do best: take care of patients.
Interestingly enough, though, med-surg units are typically that last areas to be thought of for medical device integration. Walk into any critical care area and you’ll likely see monitors feeding to a central station that, in turn, feeds directly to an EMR. Ventilators are cutting edge and their data is flowing to the EMR, as well. Conversely, walk onto a med-surg unit and you’ll likely observe nurses with tattoos of vital signs up and down their arms, or on scraps of paper that they will later transcribe. Their patients’ data is just as important as the patients sitting in the critical care unit or ER, right?
So, here’s an interesting thought to ponder: Typically, there are more med-surg beds in a facility than ER beds and critical care beds combined; therefore, there are more med-surg nurses working at any given time than there are in all the other areas put together. The med-surg areas are the backbone of the hospital. As a general cultural oddity, why is it that these areas are the last to get connected? Why are they not seen as mission critical like other areas of the hospital?
I’d like to hear your opinion as to why this is the case and how we can change this thought process.