[everthesame]

If the hospital has the capability to track who is using a computer and visiting various websites then perhaps someone in IT could print off a week long log of internet usage for the manager to distribute at the next staff meeting. The user names should be blocked out but the manager could explain that yes they do track usage and if the abuse of privileges continues some of those blocked out users will be meeting with the manager to discuss this type of behavior.


I have worked with people who have spent hours playing games or researching their next vacation on line on the hospital's time. This is not appropriate. I do think it is not unreasonable to have a computer available in the break room for use on the employee's unpaid break.

I have used a work computer to check local news channels for school closings or two hour delays on nights when we have had a snow storm. It is much quicker to check the Internet for such information than it is to stand in an empty pt room watching all of he school closings scroll ever so slowly across the bottom of the screen. Some mornings most of the staff would be in the empty room waiting to see if they needed to make other child care arrangements and nothing was getting done on the floor.

Also, I have looked up sports scores for patients who ask if I know how the game ended. It wasn't medical information, but it is such a simple thing to do for the patient that gives them a little sense of being in touch with their normal life. I think they really appreciate when I come back in and tell them I found out who won the big game.

[Owney]

My Dear Colleagues,

I have seen computers move into hospitals throughout my career. Before the internet (yes, there really was such a time) we had some PCs that were supposedly dedicated to printing out patient discharge instructions. The first time the deputy emergency medicine chief saw two medical students playing chess from a floppy drive, he had the IT folks install locks that kept the "patient instruction" floppies locked into place. Were these folks abusing their privileges? Most likely--but if they were third year students, they probably signed up for ER elective in order to learn. Evidently they felt they learned more by playing chess--since most of the staff (except us nurses) treated them like useless furniture, especially when the ER got really busy.

I heard about another large hospital system that had nursing documentation software written by folks who were brilliant software authors. They never sought input from nurses, just put it on the system and hospital administrators issued an imperial decree that it be used. Needless to say, it failed miserably. God knows how much nursing documentation and patient needs suffered during the failed trial.

I have heard that there are good nursing documentation systems in place these days. I should consider myself fortunate to have retired during the last days of pen-and-paper documentation.

I worked in a huge medical center whose entire university computer system was in the basement of the hospital. The IT folks were so helpful that if you brought them a box of floppies, they would give you software to access the system from your home. (I know they could not do this today without blocking access to medical records.) One day a fun-loving colleague told me about a web site, which I keyed up on the computer in the middle of the treatment area. I should have known that as soon as I answered "are you at least 18 years of age?" in the affirmative, I would be bombarded with pornographic photographs so quickly that the only way to stop it was to unplug the computer. I later heard another nurse tell a resident physician that "...if you use any of our computers to access anything other than medical information, they will fire you. They have already done it to more than one person."

Bear in mind, however, this hospital had the nearly limitless resources of a HUGE university IT department to police its system. At another hospital I saw more than one physician who used hospital telephones and the internet to trade stocks (after all, how could she/he give good ER care if he/she cannot afford to fill the tank of the Jaguar or make the next medical conference/cruise). Administration looked the other way since she/he was more than "just some nurse." At other hospitals, every time I suggested that we should have nurse-to-nurse department mail, (so that we could trade days off) the response was, "If we do that, our nurses will spend all their time chatting and ignore their patients."

When I worked for the pool I worked with a physician who kept all of his patients' ER records on his laptop. Imagine today how poor he would be after the lawyers got finished with his HIPA cases. A few years ago, I got a letter from the VA about a mislaid laptop with millions of medical records. The letter said that if I suspected any of my records had been "mined" by commercial entities, I should contact the VA immediately. If any of my records had been accessed, I would hope the third-parties were my federal legislators, so that they could see what a sorry sitcom my "treatment" by the VA was.

What I have learned from my computer experience is:

1. Surf as much as I like, but cross-check all information that I dispense.
2. Never open unsolicited emails from an address that I do not recognize.
3. Never answer the question, "Are you at least 18 years of age?"
4. Never post anything that could lead to a court summons.
5. Never post anything that I would not want my mother to read.

The internet is a marvelous resource. I was breathless when I first surfed with my HSC, and was told, "YOU HAVE JUST ACCESSED 2.4 MILLION WEBSITES IN 1.2 SECONDS." What I have learned in the years since was that a large portion of that information would help me most by raking it into my tomato garden.

Over my lifetime I have seen newspapers, radio, television and internet resources evolve into entities that are best handled by two approaches:

1. Pay attention to only half of what one sees and hears.
2. Ignore the rest.

Best Regards,
Owney

[alystania]

At the facility that I work for-they have gradually reduced the amount of websites that are allowed (not blocked). Many people during the night shift were on personal websites like myspace and youtube. I feel that this practice is inappropriate to a professional working environment. There are some websites that have really useful and relevant medical information that I believe should be available if needed.

[civilianhannah]

Originally Posted by PageRespiratory!

>
I agree, but if that happens, then no one is to blame but IT. There is PUH-LENTY of filter/firewall software. Why is it that IT is the only department that can manipulate the system to make thier job easier. We make rounds to see Pt's, why can't they make rounds to see each units machines? Nope, rather have a "cushy" M - F 9-5 Dept. And wait for something to go wrong before taking any action. Not to mention blaming EVERY problem on a virus downloaded by someone "surfing". At least thats how it seems in my hospital anyway. The guys/girls in our IT are really good at what they do, I just feel the approach to the service is all wrong. As far as I'm concerned, if it's not blocked, it's fair game. Don't misunderstand me, the employee spending an extended amount of time online (or on the phone, reading, knitting, playing cards, scrapbooking, ect.), is probably not living up to thier job requirement and should be dealt with accordingly. And anyone accessing inappropriate material in the workplace, aside from being creepy, really deserves to be terminated. It's 2008, high speed internet access is baseline these days, anyone who disagrees give me a call, I've got a rotary phone and encyclopedia set for sale.

Hi. I frequently read this forum even though I don't comment often. I am not a nurse, but reading the forums is very informative and the subject matter discussed interests me a lot. You've probably encountered a lot of misconceptions about what you do, so I think you'll be sympathetic to this. There is no filter/firewall software that can completely anticipate or protect from the many ways a user can trash a computer through unsafe internet practices. It gives people a false sense of security - a commenter on another forum I read had a good example. They put some people on a computer with anti-virus software, told them about it, and they put different people on other machines and told them that there wasn't any anti-virus software on it, and that they needed to be careful. Guess which machines got infected? The ones with the software trying to protect them. Hm...I guess I could compare it to fire-protective gear. It can protect you for a certain amount of time depending on what it is, but you can't walk straight into a fire and sit down. Users really are a big problem to computer security, and preventative measures can only go so far when there's so many variables. This isn't to say that IT staff at your hospital really are, or aren't doing their jobs as that's impossible to tell over the internet, but I was just hoping to help you understand a little more about what goes on behind the scenes.

[Suesquatch]

I'm in systems, and there are several concerns with non-business internet use.

If any patient information goes out over unencrypted channels it's a potential HIPAA violation and the CIO is hung out to dry.

Sites like MySpace and FaceBook often contain malware and viruses and can infect an entire system, and provide entree via Trojan Horse programs.

Where I work, our bandwidth is extremely limited and there would be hell to pay if orders weren't transmitted quickly because someone was booking a trip to Disney World.

That said, I would be lost if I couldn't check business-related sites - such as eMedicine.com.

[Turtle in scrubs]

Got to say I can clearly see both sides, but as a new grad there are so many things I want to look up and it is frustrating not to be able to. I rarely take lunch and have to remind myself to drink and pee - can't imagine the day when I would have time to do anything non-work realted on the computer.

[aeauooo]

Originally Posted by Michiganag

Got to say I can clearly see both sides, but as a new grad there are so many things I want to look up and it is frustrating not to be able to.

That's what textbooks and handbooks are for.

Many of us remember the time when no one had ever heard the word "Internet."

Internet access at work is a convenience, but not a necessity

[Jess1983]

wow really?

[Tweety]

I think having internet at work is invaluable. I Google all the time.

But to me surfing the net is no worse than thumbing through a magazine while on the clock. Surfing or magazine reading should never interfere with patient care.

I post from work frequently when I have a few minutes, or there's an issue that I just can't wait to resolve. Usually I'm way too busy.

I'd be very wary of doing my banking from a computer that isn't my home computer...password protected or not.

[MiaKea]

As a student, the last unit that I was on in a VERY BIG city hospital was filled with nurses and techs who spent a lot of time online (shopping at Target for Christmas gifts, playing games, pricing new cars, just to name a few).

One patient's daughter walked to the desk because her mom's call light was being ignored and wanted to know why.....and then I guess caught a glimpse of the Target website up and visible for all to see. She didn't do anything at that time, but apparently she went all the way up the chain of command in the hospital....and eventually 2 nurses & 2 techs lost their jobs. I don't think they lost their jobs for just that particular occurrence, but they pulled logs of internet activity and tracked their time online.

I am not a techie person so I don't know how this could have been tracked, but I do know that 4 people lost their job because when they should have been providing patient care they were surfing the web (with a lot of documentation logged on their internet use).