Is 'Nursing Informatics' really a 'Nursing' specialty?

Specialties Informatics

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  1. Is 'Nursing Informatics' really a 'Nursing' specialty?

    • 37
      Yes
    • 11
      Yes, but I wouldn't bother countering his argument
    • 5
      No
    • 1
      No, but I wouldn't bother countering your argument

13 members have participated

Is 'Nursing Informatics' really a nursing specialty?

The following is a discussion that is taking place right now in one of my classes. We were just discussing competencies for each of our chosen nursing specialties. It somehow led to this conversation which, if the management student's view is right, means that I am doing my MSN in a non-nursing specialty!

Since so many informatics nurses and wannabe informatics nurses frequent this forum, what better place to ask this question than here!

So...

How would you respond to this MSN (Nursing Management) Student (gentleman)?

Dear MSN (Nursing Management) Student,

Very detailed posting that included all the different points.

Every specialty area in nursing has developed competency statements. For example:

Curran, C. R. (2003). Informatics competencies for nurse practitioners. AACN Clinical Issues: Advanced Practice in Acute & Critical Care, 14, 320-330.

Not sure if Informatics is the same/similar to CSM.

APA: Is Stetson a journal article? Need to include specific source. Where is it posted or linked? Electronic source or something else?

- MSN (Nursing Theory) Professor

Dear MSN (Nursing Theory) Professor,

They are not the same. Informatics is a part of Clinical Systems Management by virtue of the fact that in a complex adaptive system of healthcare, computerization, EMRs and hence informatics has come to occupy an increasingly important role.

Stenson (2006) is not a journal article - it is a website that has been cited in the description of this week's discussion forum on the main page of the 'discussion' area.

- MSN (Nursing Informatics) Student

Dear MSN (Nursing Informatics) Student,

At the risk of alienating nurses who work in nursing informatics I want to make an observation related to nursing informatics. Informatics is really not a nursing specialty. Informatics is part of the organizational infrastructure (i.e. IT, MIS). I've worked in IT for major (non-healthcare) corporations for decades prior to becoming an RN. None of these corporations identify informatics as part of their main business. For example, there isn't a stockbroker informatics specialty or is there an accountant informatics specialty yet there is a nursing informatics specialty. Informatics is a specialty unto itself regardless if informatics is used in healthcare, Wall Street or WalMart. Professionals who work in informatics typically have degrees in MIS or computer science and are able to identify and translate business requirements into a working computer application (i.e. EMR, CPOE, EMAR) with the assistance of business professionals (i.e. nurses, physicians). Now that I probably got myself in trouble with everyone who is majoring in nursing informatics (my apology :) ), I have to agree with MSN (Nursing Informatics) Student that informatics is part of clinical systems management, however informatics is a support service to clinical systems management just like other areas of MIS (i.e. networking, hardware.)

- MSN (Nursing Management) Student

Dear MSN (Nursing Management) Student,

Based on this observation, then, would you be able to say educational programs and certifications and research activities towards expanding the knowledge base of 'specialties' like health informatics or medical informatics or bioinformatics or nursing informatics are merely trying to exploit the job market to attract nurses or other healthcare professionals who wish to be involved in the informatics arena?

- MSN (Nursing Informatics) Student

Dear MSN (Nursing Informatics) Student,

I think what is happening is that the healthcare industry embraced informatics within the last 10 years where other industries have built their industry around informatics for decades. The assumption seems to be that informatics is a new field of nursing and therefore programs (i.e. certifications) are established to qualify nurses for this new specialty. Exploitation is probably too harsh of a word. Instead I believe we're seeing an evolutionary step in what has become nursing tradition to be certified in a specialty. Since I'm coming from a non-healthcare industry where I was heavily involved in designing and building computer applications, I'm puzzled why informatics is a nursing specialty. Systems analysts, programmers, project managers have the necessary background to develop and implement EMR, CPOE, EMAR and other healthcare informatics systems. On Wall Street, managers ask the IT department - not a trader - to handle informatics. So why shouldn't the hospital administrator ask the IT department to handle informatics? As the healthcare industry becomes more comfortable with informatics, I think informatics will become a support function as it is in other industries. With that said, I found informatics a fantastic field that can have a dramatic effect on the organization's operations. I'm sure training in nursing informatics will provide the same skill-sets as IT professionals who perform a similar job in non-healthcare industries.

- MSN (Nursing Management) Student

Dear MSN (Nursing Management) Student,

The difference is that nursing informatics encourages the development of IT competencies in addition to the already developed/developing nursing competencies that a nurse possesses.

We have seasoned IT professionals in our department who are not able to understand the end-user's needs even after multiple meetings because they lack the nursing competencies. It is not their fault if they do not understand the nursing workflow and/or the reason for it.

One of the advantages of a nursing informaticist is that he/she can speak/understand nursing lingo as well as IT lingo. They're able to leverage knowledge from both areas of expertise to develop/ troubleshoot/ build/ maintain/ improve a system that is truly beneficial in helping the healthcare provide enhance the quality of patient care.

Have you heard about pharmacy informaticists, laboratory informaticists, and radiology informaticists? I believe the reasoning behind those specializations is also the same / similar.

- MSN (Nursing Informatics) Student

Dear MSN (Nursing Management) Student,

In other industries, there are business analyst and systems analyst. A business analyst compiles business rules from business operations by talking with all stakeholders. The business rules are handed to a systems analyst who translates those rules in a logical flow (pseudo code) that programmers convert into the application. It is common for a person knowledgeable of the business taking on the role of a business analyst for the project and then returns to his normal job once the analysis is completed. Therefore, the nurse informatics specialists would fill the job as the business analyst.

From my IT experience, the problem you describe is an experience problem. An IT person not familiar with the business is learning the business while trying to learn business rules. An IT person who is familiar with the business (i.e. worked on several EMR implementations) would understand the lingo and what the business rules are - and should be. My latter point (i.e. should be) is very important. Not all policies and procedures are followed therefore the business rules presented by the nursing staff to the IT analyst may not be the same as policies and procedures. I recall being that IT person once at a Wall Street firm. A trader showed me rules he followed doing his job. I confirmed that with his boss - and she said "that's not how we do it."

My point is that a nursing informatics specialists is moving from nursing (i.e. caring for patients) into IT, which not a problem. However, I don't think nursing informatics is really a nursing specialty as compared to emergency nursing, critical care nursing, or behavioral health nurse.

- MSN (Nursing Management) Student

Dear MSN (Nursing Management) Student and MSN (Nursing Informatics) Student,

Thanks for your comments. It is interesting that nursing, as a profession, has many specialties and sub-specialties with their own areas of interest, education, and certification. When groups of nurses first started focusing on the use of technology in practice, informatics was born. I believe it was related to the level of technology available at the time. As pointed out, technology has expanded to all areas of work to broadly include complex systems management.

Very interesting discussion on the topic which expands everyone's knowledge and perspective.

- MSN (Nursing Theory) Professor

Would you continue the discussion if you were in my place?

Or would you just let the ignorant wallow in their bliss for the sake of your sanity?

By that standard, even nursing management (CSM) would not qualify as a nursing specialty - since management is part of every industry and not exclusive to nursing - and since a nurse manager moves from nursing (i.e. caring for patients) into management - right?

Dear MSN (Nursing Management) Student,

By that standard, even nursing management (CSM) would not qualify as a nursing specialty - since management is part of every industry and not exclusive to nursing - and since a nurse manager moves from nursing (i.e. caring for patients) into management - right?

- MSN (Nusing Informatics) Student

157 views, but no comments on this thread so far!

I would think that means no one would actually bother to engage with someone who holds the opinion that nursing informatics is not really a nursing specialty.

Meanwhile, Mr. MSN (Nursing Management) Student has already made his next argument as follows:

Dear MSN (Nursing Informatics) Student,

You make an interesting point. However, the function of a nurse in nursing informatics is the same as a business analyst, systems analysts, project manager and other roles that falls under MIS that are part of the MIS/computer science curriculum, which is my point.

There are various levels of nurse manager from a unit manager to chief nursing officer. These are obvious part of the nursing role. With that said, a nurse who becomes an administer who operates a major division of a healthcare facility is moving away from nursing and more towards public health administration, which is a different academic discipline.

Another way of looking at this issue is that you don't have to be a nurse to be in healthcare informatics. You could be trained in MIS. Likewise, you don't have to be a nurse to be in public health administration. You could major in public health administration. However, you must be a nurse to be a nurse manager.

- MSN (Nursing Management) Student

At the time of this post, 168 views, and not a single comment/response to the question...

Anyway, here's the next response in this discussion:

Dear MSN (Nursing Management) Student,

By the same standard, the function of a nurse in nursing management is the same as a business manager at various levels of the business management hierarchy.

There are various levels of a nurse informaticist from nursing applications analyst to clinical applications specialist to clinical applications manager to chief nursing information officer (CNIO). These are inevitable parts of the nursing role since nurses who work at a facility that uses some kind of clinical information systems (CIS) cannot function without their informatics counterparts.

Based on personal experience, the programmer analysts, network analysts, database analysts, system analysts, business analysts, and other non-clinical roles who have worked for 10+ years in our hospital's MIS department find it beyond their ability to be able to support clinicians or even comprehend their support needs, new/improved functionality needs, workflow needs, reporting needs, etc. They come from varied IS/IT backgrounds such as IBM, SAP, and other well know names in the field. Is that because these non-clinical IS/IT personnel are inexperienced with the healthcare information systems (HCIS) or just inept? Neither!

It is because not every clinical (nursing, radiology, pharmacy, laboratory) informaticist is a second-career person with knowledge and experience in both IS/IT and clinical areas under their belt. It would be unreasonable to demand that the minimum requirement for clinical informaticists should be a dual degree in IS/IT and nursing/radiology/pharmacy/laboratory. That is where the informaticist roles come in - the purely clinical and the purely non-clinical MIS roles work together with each other in harmony to create a system that works for that specific hospital.

In the same vein as what you said in the last paragraph of your response:

Just as you don't have to be a nurse to be in healthcare informatics, you don't have to be a nurse to be in healthcare management. However, you have to be a nurse to be in nursing informatics (Informatics Nursing Certification Eligibility Criteria), and you have be a nurse to be in nursing management (Nurse Executive Certification Eligibility Criteria).

- MSN (Nursing Informatics) Student

I'm going into informatics and I have never been this excited about going to school or any other area of nursing or healthcare.

I'll be honest I saw the post but didn't read all of it because it was way too long. This maybe why so many views but no one else made a comment. Not that your post isn't relevant it's just a lot of info at one time. And I'm using this forum on my iPhone so it takes me a while to read through everything.

Sent from my iPhone using allnurses.com

Specializes in Med/Surg,Cardiac.
I'm going into informatics and I have never been this excited about going to school or any other area of nursing or healthcare.

I'll be honest I saw the post but didn't read all of it because it was way too long. This maybe why so many views but no one else made a comment. Not that your post isn't relevant it's just a lot of info at one time. And I'm using this forum on my iPhone so it takes me a while to read through everything.

Sent from my iPhone using allnurses.com

I agree that the post was very long and that is probably the reason for less responses. I have an interest in informatics as well. I do view it as encompassing more IT than nursing, but that nursing background assists in modifying programs to be more user friendly, and in hospitals, that's mainly nursing.

~ No One Can Make You Feel Inferior Without Your Consent -Eleanor Roosevelt ~

Specializes in Med-Surg, Nursing Informatics.

All I can say is what a dialogue and I totally disagree with MSN Nursing Management person. When I first entered nursing informatics in 2001 I was bombarded with others who were building their portion of our new HIS at that facility telling me that I was no longer a nurse. No longer a NURSE? I wondered if that were true. Hmm. let's think. I use my nursing background everyday. Be it knowing how nurses do their job everyday at the frontline, how orders process through the system, how physicians enter orders and how nurses carry out those orders, how they document the care given the patient, how they develop a plan of care, how they administer medications. How pharmacists interact with nursing, how labs get ordered, resulted and communicated, how other departments work with nursing. I currently work in another facility and I am proud to say we have a Department of Clinical Informatics of which I am ONE of the nurses. This hospital as others are realizing, an IT person can build, but they don't know clinical like we nurses do! We actually have 4 full time nurses in our department. 2 of us work with inpatient areas, 2 work with the ambulatory side. The other hospital I worked at for 37 years? They also have learned the value of having nurses in IT. You can teach a nurse IT, but you cannot teach an IT person nursing.

So I proudly say, that YES Nursing Informatics is a NURSING specialty!

I'm going into informatics and I have never been this excited about going to school or any other area of nursing or healthcare.

All the best!

I'll be honest I saw the post but didn't read all of it because it was way too long. This maybe why so many views but no one else made a comment. Not that your post isn't relevant it's just a lot of info at one time. And I'm using this forum on my iPhone so it takes me a while to read through everything.

Makes sense :)

I agree that the post was very long and that is probably the reason for less responses. I have an interest in informatics as well. I do view it as encompassing more IT than nursing, but that nursing background assists in modifying programs to be more user friendly, and in hospitals, that's mainly nursing.

When two people agree, that's gotta be why :)

And if you decide to pursue your interest in informatics, I wish you all the best!

All I can say is what a dialogue and I totally disagree with MSN Nursing Management person. When I first entered nursing informatics in 2001 I was bombarded with others who were building their portion of our new HIS at that facility telling me that I was no longer a nurse. No longer a NURSE? I wondered if that were true. Hmm. let's think. I use my nursing background everyday. Be it knowing how nurses do their job everyday at the frontline, how orders process through the system, how physicians enter orders and how nurses carry out those orders, how they document the care given the patient, how they develop a plan of care, how they administer medications. How pharmacists interact with nursing, how labs get ordered, resulted and communicated, how other departments work with nursing. I currently work in another facility and I am proud to say we have a Department of Clinical Informatics of which I am ONE of the nurses. This hospital as others are realizing, an IT person can build, but they don't know clinical like we nurses do! We actually have 4 full time nurses in our department. 2 of us work with inpatient areas, 2 work with the ambulatory side. The other hospital I worked at for 37 years? They also have learned the value of having nurses in IT. You can teach a nurse IT, but you cannot teach an IT person nursing.

So I proudly say, that YES Nursing Informatics is a NURSING specialty!

Thank you - you've been in my shoes :)

Specializes in Management, Med/Surg, Clinical Trainer.
I use my nursing background everyday. Be it knowing how nurses do their job everyday at the frontline, how orders process through the system, how physicians enter orders and how nurses carry out those orders, how they document the care given the patient, how they develop a plan of care, how they administer medications. How pharmacists interact with nursing, how labs get ordered, resulted and communicated, how other departments work with nursing.

I agree and this argument can be levied for any job that is out of the traditional bedside nursing arena. I am not really sure why some nurses feel that if someone is not got their hands in poo, then they are not a nurse. Nursing can be hands on, but it is also so much more.

....You can teach a nurse IT, but you cannot teach an IT person nursing.

Here is where I politely disagree, an IT person can be taught 'nursing.' By the definition of nursing given in the post; nurses know how orders process,

how physicians enter orders and how nurses carry out those orders,

how they document the care given the patient,

how they develop a plan of care,

how they administer medications.

How pharmacists interact with nursing,

how labs get ordered, resulted and communicated, and how other departments work with nursing.

An IT person does not need to be taught the absolute hows or whys - the 5 rights of med dosage etc. They only need to know how the staff interact with the EMR and most of what you describe as nursing actions will turn into interactions with the EMR, except for maybe the plan of care [and not all EMRs have them imbedded in their tool].

Granted, it is helpful if an IT person has some knowledge of the work flows in care delivery, just to make it easier on them, but it does not have to be nursing care. Many EMRs now have templates and workflows imbedded in them. So they would not need to learn the exact process they would only need to learn how to pull out the relevant data needed for Meaningful Use, Billing etc.

Specializes in Nursing Professional Development.

My doctoral dissertation arose out of that question. My conclusion was that Nursing Informatics CAN be nursing if the person approaches the topic from a nursing perspective (nursing philosophy, theory, culture, ethos, etc.). However, it can be Informatics focusing on a nursing situation if the person approaches/views the situation from only an Informatics perspective.

In other words ... it can be either Nursing or Informatics depending on how the person views/considers the situation. Do they use a nursing perspective or an informatics one? That is the key.

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