So my hospital has officially "gone live." We aren't charting everything on computers yet. Just doing the EMAR, med rec, height/wt/allergies. The ER is completely live but the floors are not. So Tuesday I was working and it was the first day we went live with the EMAR and scanners.. You know you have to scan the patient's bracelet then scan the pills. Well we have to use these "COWs" but we can't call them cows because that is offensive.. so they are called "WOWs" (work station on wheels).
So they weigh like 200lbs each. My floor is the only floor that still has carpet. So I have to push this machine all the way down the hall (on carpet) and into a patients room EVERYTIME i have to give a pill, hang fluid, apply butt cream... It is really stupid. Did we get portable scanners??? NO, they thought someone would steal it. I have a patient moaning in pain and here I am with the morphine... trying to push this 200lb machine over the door threshold, making all kind of noise. Then scan the patient, scan the med, and enter all their vitals before I can administer the morphine... And when giving insulin we have to have a nurse witness the insulin at the bedside and enter there name and password.. We have 36 patients on our floor and probably 25 are on sliding scale.
I'm spending so much time with this stupid WOW and NO time with my patients... Please tell me it will get better. I'm so overwhelmed!! And I'm 23 and very computer savvy.... We have nurses and CNAs who can't even work a mouse!!!!!
The second nurse needs to manually enter his/her employee number and password after the first nurse has accepted the dose, route, etc. His/her initals then show up on the EMAR next to the original nurse's. I suppose if someone knew your employee number and password they could use it w/o you knowing. But, there is at least an attempt built into the software by requiring the password to prevent an unauthorized use of another nurse's name.
our hospital has ships that we use to carry meds in a locked drawer, and chart at the bedside...also have portable handhelds to use for iso rooms and so forth...when it comes to insulin, it is expected that you already had someone witness it at the station...so you don't need to rewitness it....kind of redundant and what if you need it in a hurry. Lots of people wind up back charting with a scan code because of the lack of time...
It took a good 5 months to get things down...it still causes problems once in a while...but it takes getting used to. Nothing is perfect.
Background: I'm not a nurse. I've been accepted into an ADN program and will be beginning in August and anticipating graduating in June 2010. I've been a programmer analyst, systems analyst, systems engineer, IT Manager, and Project Manager. I've been a volunteer for the past 6 months in the Emergency Department of a local hospital. (Helping patients and learning about nursing, but avoiding system or I.T. discussions. Most if not all of the staff are unaware of my background and expertise.)
This is a pretty good discussion. When posting, it's helpful if you start out with:
System: (Meditech, Cerner, etc)
Area: ER, NICU, etc.
ERCOWSs and WOWs are frequently labeled on the computers. I agree that they look clunky and do not represent the best that technology has to offer.
I recently saw a demonstration of a rugged tablet PC that was explicitly developed for the hospital environments. I was surprised that it weighed less than 3 lbs, included a barcode and rfid scanner, and cost less than the COWs. When I later spoke with the ED Director, he wasn't very interested. As an ED director, he obviously was not aware of discussions such as these!
Actively collaborating with your IT Department to maximize our value as nurses will ultimately improve patient care.
The computers are often loaded with a lojack. Actively raising awareness of this fact will usually discourage theft. Additionally, the computers that are typically used as terminal type devices with scanners are rarely useful for home computing purposes.:chuckle
ADPIE...Your name brings back memories of Nursing School! You hit the nail on the head as far as the Manager not being interested in your suggestion. The computers in our hospital were placed there for us to use with an almost nonexistant training program. (We had plenty of time to play with them but when we asked, "So how do I chart...." we were told, "Well, we're not sure how it will look once we go live but we think you'll probably do it like this....". Then, it was horrible when we went live and we all had to learn it on the fly. But when we started trying to give input on how to make it more convenient for us we were told that this was the system in place and we had to live with it. Our complaint was that we needed someone that worked in our department everyday, to use the computer and then attend the meetings telling the computer gurus what works and what doesn't. All we've heard are excuses about why we have to all do it the same way through different hospitals, even though it's not efficient for us. Honestly....four different screens to chart the discharge time? Things like that make you want to scream when you're so busy. SO INEFFICIENT! I looked forward to going live because I love computers. But now....give me my paper!
I think the answer is to have the nurses chart info on paper and then give the data to data entry clerks to enter. That way...I know this is a new approach....nurses could do nursing duties and HUCs could do data entry!
MNmom3boys
169 Posts
The second nurse needs to manually enter his/her employee number and password after the first nurse has accepted the dose, route, etc. His/her initals then show up on the EMAR next to the original nurse's. I suppose if someone knew your employee number and password they could use it w/o you knowing. But, there is at least an attempt built into the software by requiring the password to prevent an unauthorized use of another nurse's name.