Students nursing during EMR go-live

[jappey17]

Hi all,

I am an educator in an acute care 400+ bed hospital. We will be going live with our electronic system in September 2012. I also coordinate nursing students. Our hospital wants to NOT have any students during go-live, however, I believe differently. I think student nurses may serve as extra hands to do basic things e.g. passing out water, bringing linen into the room, providing baths to the patients etc. While nurses are learning (we are paying lot of attention to training btw) and dealing with the new system, students can be extra hands.

I want to know if any hospitals have allowed nursing students during go-live and how did it go? What strategies were used, was there a limitation on how many students were allowed, what semester students were allowed. I will take whatever information I can get.

Above all, how did it go for the bedside staff? Were the students any help or a burden? Any feedback is appreciated.

Thank you,

Jaspreet

[halfpast]

I was a student nurse last spring of 2011 doing my final 200 hour preceptorship in a hospital that was just about to go-live with their EMR. I was working one-on-one with a nurse. I actually found it to be helpful- as many "younger" nurses/students are more handy with the computer, I was able to take the electronic documentation class, and was actually able to teach my preceptor many things about the program and how to use the documentation system.

As far as having groups of students around, I think it could be helpful. It's always nice to know that one of your patients have a student-- just another pair of hands to help out, and you can bet that some of the nurses will need it! We had two nurses leave our hospital (one went into early retirement) and they made it know that it was because we were switching over to EMR.

I, however, love EMR and EMAR!! Makes documentation so much easier!

[roser13, ASN, RN]

Well hello negative nancy.

Not negative. Realistic.Are you a student, by any chance?

[tcvnurse, BSN, RN]

Well hello negative nancy.

No. That is reality.

To the OP. If you really want to help your floor nurses, order some pizzas for lunch that day.Most wont have time to leave the unit to buy food. My manager had some energy drinks on ice for ice. The administration made rounds with a gigantic bowl of mini chocolate bars and kisses as Chocolate makes everything better.

Extra staffing would be the best thing. I remember being so frustrated I could scream as I couldn't figure out why my meds wouldn't scan right, how to find information on the EMR and lots and lots of other issues.

There will be PLENTY of stress for your nurses. Students would be adding to it.

[missladyrn]

At the place I did externship I was there for a new computer system, completely different from what they had been using before. I found the system to be quick and easy to use, the rest of the staff spent the entire week complaining about how different it was and how they didn't like it. It took them a long time ton chart but mostly becuase of all the commoserating. I had nothing to compare it to. Fast forward to my current job, now I am the one complaining about the new system and comparing it to the old one. Once you get used to where to click and how to fly through it really slows you down to have to relearn and retrain your brain.

I think it should be an " all hands on deck" situation where they should overstaff on purpose to give people time to learn the kinks of the new system. The students would be ok, but only if they know that they are there as gophers. Otherwise, there should be a lot of EXTRA regular staff on for the first week or so of the launch. And managers and such should be on the floor as well, doing what they can for the patients while the staff is tied to the computer. That will never happen, but that is what they should do.

[classicdame, MSN, EdD]

we went live last November and I had the January students on the computer. I created a cheat sheet for them and, during orientation, showed them how to access and where they can view or document. We have restricted documentation to flowsheets, vitals, I&O, and notes. They may view anything in the chart, just like a paper chart. Ahead of time I get their names, complete forms for IS to put them in computer. Access "dies" the day after last clinical date. At orientation they get their ID/PW and I give a list of those to instructor. They sign pertinent confidentiality forms. So far we have had NO ISSUES.

[AOx1]

As a nurse educator, I would not choose to have my students on the floor unless their objectives were to provide basic care alone (ex-1st semester students). Of course, all students continue to provide basic care in all semesters, but this alone is not sufficient for them to meet their clinical objectives.

I would want to ensure that my students: were adequately supervised, could meet objectives, would not be a hindrance and add to the stress, etc. The problems I see are that only my early 1st semester students could have objectives fully met by doing such basic care, yet early 1st semester students need the most supervision and are already stressed.Having been through 2 of these transitions, I don't think this is a good idea for some students, although 1st semesters supervised by instructors could be helpful IF the staff prefers it. While I would obviously supervise my own students, they might still ask questions of staff, adding to stress levels.

In part the answer depends on how well the staff has been prepped and trained for the transition and how much IT support will be available. Most importantly, what do the floor nurses think? They should be the ones to decide.

[VICEDRN, BSN, RN]

Don't think it sounds fair to the students or the nurses that precept them. Nursing students can be both a drag (you have to stop and explain everything) and a help (they function independently when ambitious and the task appropriate to their situation) but ultimately I think will not benefit from the experience as much as they could from other clinical experiences.

As we have discussed around these parts many times, the clinical experience of a student is so limited that I think it wise not to take away from any clinical experience they have.

The go live will also make everyone ill humored. Is that setting a good example for the students?

[classicdame, MSN, EdD]

Agree with AOx1. The students are not slaves. I have to keep reminding staff that the students may or may not have total care of the patient, depending on objectives. For instance, not all are allowed to give narcotics or start IV's. Charting is essential to taking care of the patient.

[tothepointeLVN, LVN]

Not an EMR go live per say but when I was in school our local county hospital moved from their old building to the state of the art new one. All the nursing students from all the students were still expected to show up and help if it occurred during their clinical time. Students for the most part WANT to be helpful and won't look on scut work as being beneath them so much. One of my favorite moments from nursing school was being able to take a active part in an internal disaster drill. Of course I wish they had told me it was a drill before I took vitals on all the new incoming "patients"

[whichone'spink, BSN, RN]

I have worked on the night we updated to the newest version of Meditech. Even with extra staff, the ED was a hell hole that night. I don't think the floor was all that different. Not a good environment for students to work in, unless they have worked on the floor for a few shifts already and they are used to the routine. I have also worked on days when Meditech went down, and everyone runs around like headless chickens, myself included. It sucks during such a big transition, or outage. Just plain sucks.

[Morainey, BSN, RN]

I know how confusing and upsetting EMR updates and downtime can be, everything runs amok. I personally would keep students off the floor. Frustrated, frazzled nurses aren't conducive to teaching impressionable students. More ancillary staff might not be a bad idea though.

[Jenni811, RN]

Out of curiousity... have you EVER actually worked with a nursing student?? I don't feel you should be making this call if you have never worked with a nursing student.

A student slows you down. They are not "extra hands" because a student is not there to pass water, take people to the bathroom or answer call lights. It takes me 2 minutes to get someone a glass of water but an extra 30 minutes to do ONE patient's medications with a nursing student, and i still have 3 other patients to go. Students are extra stress on a nurse. So unless you plan on taking all the students yourself, and spendng that extra "30 minutes on each patient for medications" then by all means, bring in the students. But the floor nurses, they don't have time!

I am speaking on behaf of the staff nurses at your hospital. do NOT bring in students...you probably will forever be hated and everyone will talk about you behind your back :) (I'm a floor nurse and trust me...i know what goes on when things like this get put upon us)