Since you are retiring in two weeks, (congratulations BTW), all of this crap will be someone else's problem..................................fishing is fun!

I just completed my first ever overnight stay in a hospital, as a patient. I disagree with most of what you say, but I realize that I do not have your personal experience from which to draw.

My wrist band did have a bar code and it was scanned every time I was given something, as was the substance I was given. I managed to keep my wrist band on.

At least with computers, the information is much easier to review than if it were filed away in a cabinet somewhere and some clerk had to retrieve it if anyone wanted to review the files.

I'm guessing the point of all that is information management. All that data goes into some spreadsheet that tracks all those tiny details and kicks out a quarterly report that is discussed in a meeting that tracks costs, funding, et cetera. Some managers are just anal about trying to track all that information and to control how it is gathered, accessed and used. I'm sure a lot of it is pointless, but they've got to keep the insurance companies happy, the AMA happy, the board of directors happy and the government regulators happy. (Notice I didn't say anything about keeping the patients or employees happy. As an employee, your reward is you get to keep your job. Or slightly better in your case since, you get to retire soon.) Well, nurses are in high demand, so once you retire formally you could continue working as a nurse in a less stressful, less computer-intense environment.

And to answer your question, yes -- my computer made me type this reply.

There's a certain amount of 'research' being done now by compiling statistics from medical data of this type.

The point of the forms is to have uniform data categories for the machine to process.

As a result, it is dehumanizing for the patient and caregiver. The specific case is no longer commented in the way it was formerly done. Instead the data must be something that fits into a form.

I can understand using a computer and bar-code. It eliminates the problem with trying to understand handwriting, which can be bad, or the person may not be best at English.

In grocery stores, the computer and bar-code reader are one, not too heavy. I think it transmits back to the main stock computer. Check them out, they have cool holsters, too.

If a patient took off his wrist band, I would call security immediately and have security call the family, make a big deal of it. Anyone without a wrist band is not a patient!

It's malpractice insurance rules that force a lot of bureaucracy, you are not going to avoid them.

Interestingly, physicians still continue to handwrite( illegibly) orders and notes. They refuse to enter them themselves. That way they could be held more accountable for their mistakes. They rarely use computer input. They also continue to dictate their notes, which is inviting errors. Physician handwriting is probably the number one cause of medication errors. I have to spend a lot of time double checking order entries because of this. So we have the worst of both worlds. They are even to lazy to turn the note page over to the next page and prefer to waste paper and create an opportunity for false entries made later. I have to X out those pages, so we turn the page over for them! They also do not time their orders, that would require an extra 2 seconds and is a requirement.My wife is a Nurse Practitoner and fulfills all the duties of a family physician. She was an RN for 25 years first. It will be interesting to see when the Docs start doing their part with computers.

Actually we became slaves for every thing is materialistic.

Actually we became slaves for every thing is materialistic.

Starting from the Dollar $$$$$$$$$$$$$$$$$...............and up.

Good point!

You got the answer in your last sentence. Computers are tools that do as they are programmed to do. When programmed by control freaks, they waste time, generate frustration and divert man-hours from worthwhile tasks...like actually caring for patients! Naturally all this occurs in the name of "efficiency."

If I were in your shoes (and not retiring in a couple of weeks), I would see to it that the computers suffered a string of unfortunate accidents, mostly due to spillage of the water from the water cup that the unfortunate nurse is forced to carry in addition to the laptop, medication, instruments and whatever. Fortunately, there would always be a pad and a pencil handy...

Hello Guest Nurse ...

First, may I say (and from the heart), I have the highest regard for your profession. Often a lot of work with little recognition.

With regards to being a 'slave' to the computer, quite literally, we are not slaves to the machines (any more than a mechanic is a slave to his wrenches), but we do become 'slave-like' to the administrative organizations who dictate what we must do with those machines.

I am not in the medical profession, and that is a really good thing, considering how often my organization mis-manages the events of data-gathering. From my first exercises in such, when years ago we were implementing our first MPR (ERP, or any other acronym you want to use), I understood the pain and suffering in implementing such. GIGO (garbage in - garbage out) was the mantra, and the third-party folks in charge of implementation preached that often. This particular episode, not uncommon, I've discovered, was met with huge resistance to the point that staff refused to do the data entry, and thus the net-net of the system implementation was a huge waste of time and money. The results were never accurate, to which the constant cries arose to Dis the entire system and how 'they knew' it wouldn't work.

In my current organization, we design, develop, procure, inventory, process, manufacture, inspect, ship, and invoice for several hundred products with several thousand parts to dozens of clients. The measurement of all these transactions requires accurate data, and the ERP system (the tool) is perfectly capable of providing all the metrics and reporting all the milestones ... but, only if the data input is accurate. As with my first experience, it isn't working, because it's hard to convert 34 years of history ... and even harder to convince those who are responsible for the entire organization that the data is not valid. But, said again, the problem isn't the computer or the ERP system, but the administration of the system who manages the human systems and procedures who must provide the data.

As I know the medical profession, not only is the health and safety of the patients paramount, but the liability of the institution to not 'hurt people' is now huge. Effective data gathering is fundamental to the process, from when the washroom was last sanitized, to making sure that patient 123 got the meds prescribed to him, rather than the ones prescribed to patient 456 ... and we've all heard the stories about the patients who received the wrong surgury. One of the keys to controlling the 24/7, revolving-door operation of health care is effective data management, and one of the best tools for that is the ability to effectively gather, control, and record data. It can be done, but it is a matter of good administrative practices.

BTW, good airports do this every day, also 24/7, and they do it very well. Every passenger, every flight, every connection, every piece of luggage is known. (Okay, I am sure all of us can relate stories of when this didn't work, but imagine how it would be without the systems and procedures in place today?)

Yes, like any other imposed process, it has to be managed properly. The often forgotten element in all this IS often that the HUMAN aspects are not well considered or well handled. But, that can cover a lot more ground than just data entry.

Kind regards ... (and congratulations on your retirement ... ENJOY IT ... doctor's orders )

My experience is a little different than you portray because I work on an acute psychiatric unit. Patients are not as rational or compliant as normal patients. Good thoughts though. The bigger problem is that the data is mostly useless and will never be looked at, or quantified by anyone. It is mostly fanciful nursing care stuff. Nurses are taught to make elaborate care plans in school, which they never get to utilize in real practice. In an ideal world it would be great though. It is just not affordable. Nurses have to choose what is most important, and are continually doing that. It is not about inputting maximum computer data.

This is the solution:

I limited my time with the computer to be maximum 2.5 hr/day, i.e. only about 10% of the day hours.

As it turns out, that data may not do much good anyway.

Electronic Medical Records Not Always Linked to Better Care in Hospitals, Study Finds:

http://www.sciencedaily.com/releases/2010/12/101223130154.htm

Lots of good answers and info above. Allow me my 2 cents as a former MRP II, ERP implementor/administrator and IT manager.

No system wide data gathering system will succeed without educating the user base both in the need and expectations of the system and in detailed training in the use of the system. They also need to know the strategic (corporate) and tactical (departmental) importance of the data being collected and how it can help them and the company improve its processes, customer support and bottom line.

Also, in many companies/organizations the CULTURE of the company/organization will determine the success or failure of the system. If the senior management doesn't take an active and vocal role in the implementation process, and during the incubation period, people simply will resist using the system, or worse, will attempt to sabotage it.

I once had a department manager complain to me that a new ERP function actually added to his work load, all of about 5 minutes a day. When I showed him that his 5 minutes actually saved about 2 man hours of work per day in other departments he actually began to understand that higher level processes can actually prosper in well designed systems when small sacrifices are made at the bottom, and in total, benefit the overall organization.

I'm not saying that this hospital system described by the OP is well designed or is performing positively but it is a rare case that the end user is in a position to judge the overall functionality of a complex computerized system. It actually appears to me that an in-depth system analysis was not carried out in this case but I could be wrong as I am not there. At the very least, the system and the implementation process has apparently alienated the users and is at high risk of failure.

Bottom line, upper management MUST communicate with the staff tasked with using the system as to the importance of the success of the system, and must be willing to tweak both the systems and processes involved as necessary.

Hooker