Nurse Tracking Devices: Whats Your Opinion?
- 0Jun 26, '01 by ladybyrdThe hospital I work for has changed our classification to "associates" and "partners in healthcare". They are redoing our evaluations to reflect "objective criteria" for evaluations rather than the current "subjective criteria".
They have instituted a new computer charting system, which only the RN/LPN's can chart patient care and education. We must also chart all of the care given by the CNA/tech's. The system is very labor intensive to learn & use. It took me 20 minutes to chart 12 vital signs and I/0's for 6 patients; 30 minutes to do an admission on a new patient. (I could do ALL this in about 20 minutes on the paper system)
The hospital will soon be installing a "tracking system" for employees which is a device attached to your name tag that sends information to a centralized display (like "telemetry" cardiac monitors). They will be able to see where the staff is, how much time is spent in each location and who you are with (ie multiple employees are in a patients room providing care vs in the lounge)
They will be providing a "quality service satisfaction guarantee" to patients. It has not been fully explained to the staff, but it seems to be that if a patient has to wait longer than "x minutes" for anything, they will recieve a financial renumeration by the hospital.
The administrators are saying all of these changes "will improve health care delivery" by allowing "location of staff" and "quick communication patient needs to the appropriate staff member" and "monitor the documentation of care"
Two references about electronic monitoring:
If you work in a hospital that uses these electronic system, what is your experience with them?
MY OPINION: the potential for the employers to abuse exists when they reduce professional nursing to a "time and location study" and they "do the monday morning quarterbacking" system of evaluating your whereabouts and time your every move.
WHATS YOUR OPINION?
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- 0Jun 26, '01 by ALISHAJOELECTRONIC MONITORING???? ISN'T THAT WHAT THEY DO FOR CRIMINALS THAT ARE HOME BOUND???? How caring of your institution to want to put you right up there with the prison population!!!! I would be asking if they will also be putting these devises on administration, physicians and board members so that troubled patients and concerned family members can find them quickly to tattle on the staff!!!! looks like to me that administration is not standing behind their nursing staff!!!!! just my view of things
- 0Jun 26, '01 by Christina Terranova RNGreetings
This was aired on world News tonight on 1/4/01. There was also an article in the NYT on the issue in november, as well as an article in the American Nurse in April, 2001. If I can find them , Ill post them for you.
Every Step You Take …
Companies Using Tracking
Devices to Monitor Employees
By Betsy Stark
N E W * Y O R K, Jan. 4 — Memo to American workers: Many big employers admit they are watching you with cameras, reading your e-mails or listening in on your phone calls. And now a growing number have gone a step further.
Helps Increase Productivity*Invasion of Privacy *
****At the University of California-San Francisco Medical Center, pediatric nurses are required to wear electronic locators that monitor them wherever they go.
**** “Every time a nurse goes into a room, it records that,” says Inez Wiegig, head nurse at the center.
**** Some employees think the monitor, which also records how long a person stays in a room, makes their job easier.
**** “Things that need to be accomplished right away, you can actually find the nurse and get those things accomplished,” says nurse Nicole Hodgebloom. Helps Increase Productivity
The city of Aurora, Colo., has put tracking devices inside its sweepers and snowplows to make sure they’re being used as taxpayers intended. Supervisor and project engineer Lynn Center says it’s working.
**** “We have seen an overall increase in productivity for our units, about 15 percent, just by having the units in the vehicles,” Center says.
**** And truck driver Maria Coleman is also under constant surveillance while working. She says she doesn’t mind it, but she doesn’t kid herself about it, either.
**** “It’s Big Brother. It’s watching you, making sure you do what you’re supposed to do, but if you are doing what you’re supposed to be doing then you shouldn’t have a problem,” Coleman says. All sorts of industries are using tracking devices, among them security guards, casinos and restaurant workers and miners — often with no problem. Invasion of Privacy?
But lots of employees and civil libertarians do have a problem with workers being asked to wear electronic tracking devices, especially devices originally designed for felons on parole. They say the technology is easily abused.
**** Officials at Wyckoff Hospital in Brooklyn say they require nurses to wear personal tracking devices to improve care, but the local nursing representative calls the practice a clear violation of privacy.
**** “These badges are worn every place they go,” says Christine Terranova of the New York State Nurses Association. “If they take their break, if they go to the bathroom, it reads out on a computer-generated real-time screen and it’s logged.”
**** The nurse’s union filed a grievance against wearing the sensors but lost that battle in arbitration.
**** The pressure on nurses to account for every moment is a threat to patients, too, says Terranova.
**** “[Patients are] crying cause they just found out they have cancer, and I can’t stop for five minutes and hold their hand because I know the schematic is going to say that I spent 35 minutes there instead of five,” says Terranova.
**** The American workplace is trading privacy for efficiency, say employee advocates, and the costs are high.
**** “It can stifle all kinds of activity,” says Jeremy Gruber, legal director of the National Workrights Institute. “It can stifle union organizing, it can stifle whistle-blower activity, not to mention the lack of privacy that employees will have when they have absolutely no ability to have some individual time for themselves.”
**** An increasing number of workers have no choice but to wear the devices. In the hospital industry alone, 55,000 employees now wear an electronic monitor as a condition of employment. That means the cost of objecting to it may be their job. 
- 0Jun 26, '01 by mlvogtthe hospital I work at has already installed this system and I have to say I really actually like it. I have only heard of one instance of " tracking peoples time" and I say it was necessary. I mean when you have a cna who spends a total of 75 min in patients rooms in a 12 hour shift you have good reason to be looking into this. and the unit clerks really appreciate being able to find you for a drs call or family looking for you. Next thing at our hospital every single nurse will be receiving a mobile phone they already did it in imcu and it works great. I do understand that this monitoring system could cause problems with privacy but I think we should be open to ideas that could benefit everyone.
- 0Jun 27, '01 by ladybyrd"...when you have a cna who spends a total of 75 min in patients rooms in a 12 hour shift you have good reason to be looking into this..."
I agree that this system can be benificial for dealing with "problem employees".
However, for arguments sake, lets say you work night shift, have several "well patients" who only have a few IVPB meds and dont require more than mimimal care...
You have several who require "more than their fair share" and are in their rooms more than you are out and barely sit down the night.
The confused patient who is on the call light every 10 minutes (because they mistake the nurse button for the TV button) needs restraints to keep their IV and foley intact (and all that "new monitoring" that goes along with it these days);
One patient is a suction prn and "turn q2" and although you have suctioned him as needed, you only turned him 4 times in your 12 hours instead of the usual 6,
You have been in with someone who is bleeding and needs your 1:1 monitoring;
have restarted 3 iv's
Been on the phone with 5 separate family members of one patient who dont understand why you cant give them a detailed explanation of their loved ones condition...
Also you have been on the phone with 3 doctors and the lab trying arrange the details of the transfusion as the lab has had a difficult time getting the 2 units of rare blood type so you have been using the volume expanders till you can arrange for their ultimate transfer to ICU.
Additionally, the "mystery meat" served in the cafeteria has been at war with your GI system and you have been answering the "shouts of nature" between your other duties.
Normally, we accomplish what we can...
HOWEVER, 2.5 weeks later, your new nurse manager (and the worse one you have ever had in your 15 years as a med-surg nurse) has just returned rested and refreshed from her 2 week vacation) returns to review the new "NURSE TRACKER"...
She calls you into her office to ask for a detailed explanation for why your "perfomrmance sheet" for the nite looks like you spent an exorbitant amount of time with a couple patients, ignored others and were at the nurses station or using your moblie phone much more than any other nurse that nite. And most outrageous of all: in the bathroom 6 times once for 10 minutes!!
Suddently instead of the focus being on all that you accomplished...it turns to WHY:
"the q15 minute checks wern't done on the patient with restraints" (thankfully she fell asleep watching the test pattern on the TV)
"turned the patient 4 times not 6"....(didnt matter you suctioned him 8 times...and he was in a different position everytime you were in the room)
"you spent only 1 minutes every 3 hours in 3 rooms"...(you stuck your head in, acertained they were sleeping peacefully, the iv was running, hung their piggy back and emptied the urinal...and got it all acomplished in less than 1.5 munutes!!)
"those bathroom breaks"...(thank gawd that stress incontinence forces you to wear pads...it made the cleanup easier, but needing your stomache pumped and washing panties at work was definatly NOT what you planned when you wolfed your meal in 10 minutes...)
Well, you get the idea...
- 0Jun 27, '01 by tillie1/ we have been using a tracking system for a couple of years now. it does have some advantages: you can look on the console at the desk ans see where an employee is instead of having to run up and down the halls hollering for someone or using the "all-call" and disturbing pts. it also helps when you have an empoyee that keeps "disappearing" and argues the he/she was on the floor al the time..you can see they left the floor 35 min ago... also, if a pt c/o "havent seen any staff for hours" you have proof how often some one did go into the room. i admit, when we first started using it we all hated it for some of the same reasons cited above but i do think it is a timesaver! it is very frustrating when someone ffloats to our unit and doesn't have a tracker...can't find them for md calls, pt needs etc.
- 0Jun 27, '01 by ladybyrdTo those of you who currently use these devices, a few questions:
Does your hospital/floor have "standards" for minimum or maximum time in a patients room?
Does that minimum/maximum standard change for shifts? IE: you would naturally spend more time in a patients room that needed a procedure or personal care,(day shift) and less time if they were sleeping had no iv or meds. (night shift)
How long do you have to be "IN" the pts room before it registers that you were there?
Do staff members "leave their badge in a patients room" for a few minutes extra time off for a smoke break? (asking this question as unfortunately, I actually work with several people who would do that!)
- 0Jun 27, '01 by ALISHAJO"the unit clerks really appreciate being able to find you for a drs call or family looking for you. " .....I guess my question is how does this help the NURSE? If I am busy with a patient, then that patient becomes my priority!!!
The phone idea for each of the staff actually sounds like an excellant idea and is one that we have talked about at our facility for sometime....That way when I need Resp stat or for the House Supervisor to get something for me from one of the other departments, there is no delay while we are waiting for the pager to send the message out or to even find out that the pager tower is down (that is always fun!!!!)
"Also, if a pt c/o "havent seen any staff for hours" you have proof how often some one did go into the room. "
I am impressed!!! You mean that your QA department actually believes you!!!! The comment that I got from ours was.." the patients say that the doctor and nurse can document anything that they want but that is not what he/she (patient) is being told. THEREFORE, THE PATIENT IS ALWAYS RIGHT! Sometimes your proof is not enough....In my first year of working as an RN on a Med/Surg floor on nights, the family of one of my dying patients complained to administration that I had not been in the room all night long to check on her. So I got wrote up for it. My question to them was how could I have been getting those hourly urine outputs then, since you have to go in and empty the urine bag every hour to obtain them. My arms don't reach all the way to the second bed from the hallway and my eyesight is not up there with Superman that I can see thru curtains and the bed and the patient. I did not feel that I needed to wake the family to obtain this. My Supervisor's suggestion: Kick the chair legs under the visitors chairs each time that I went in the room the next night.
"It allows me to know ahead of time what my pt wants and to meet their needs quicker. " Can you explain how it does this?