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

Sam J. · Feb 2, 2014

Nursing Informatics is an antiquated term for Health Information Technolgy. HIT encompasses dozens of specialty fields, and 'all' of them are better suited to actual nurses than to lay people that obtain IT or HIT degrees (or certifications, if even that). If nursing weren't so divisive, there wouldn't be such a flurry of new occupations forming all of the time to replace actual nurses with lay people, whether that be ancillary jobs such as MAs, PCTs, PCAs, med techs, etc. or office people operating in practice management, medical billing and coding, insurance, case management, and a million other areas of healthcare. None of these people has the needed knowledge of what the totality of health care involves. And increasingly, these clueless people are in a position to determine what health needs a patient has, and whether or not to pay for it- even if they don't know the difference between a colonoscopy and a brain tumor, without looking it up in their manuals. This is a much larger issue than has been presented.

Info(RN)matics · Feb 3, 2014

If nursing weren't so divisive, there wouldn't be such a flurry of new occupations forming all of the time to replace actual nurses with lay people, whether that be ancillary jobs such as MAs, PCTs, PCAs, med techs, etc. or office people operating in practice management, medical billing and coding, insurance, case management, and a million other areas of healthcare. None of these people has the needed knowledge of what the totality of health care involves. And increasingly, these clueless people are in a position to determine what health needs a patient has, and whether or not to pay for it - even if they don't know the difference between a colonoscopy and a brain tumor, without looking it up in their manuals. This is a much larger issue than has been presented.

Ha ha... we'll have a discussion on our hands if someone in your target population takes the bait :)

BCRNA · Feb 3, 2014

The purpose of nursing informatics is to assist nurses in using information to provide nursing care (facilitating the use of data to create wisdom). A IT department can create software programs and implement technology into clinical settings, but failure to fully evaluate the nursing work environment is one of the leading causes of failed implementations. A programmer can create a system that is perfect by their standards, but is completely useless by the endusers. Informatics in nursing focuses on the information flow needed to provide nursing care. Nursing informatics is needed to bridge the "techs" with the nurses. "Techs" have no clue what the information needs of nurses are. Just ask any informatics nurse who has had to implement a system that was initially led by only programmers, who waited until the end to ask nurses how they will actually use the system. I have seen a particular implementation be completely unused because it was designed without the nurses workflow in mind.

Info(RN)matics · Feb 3, 2014

The purpose of nursing informatics is to assist nurses in using information to provide nursing care (facilitating the use of data to create wisdom). A IT department can create software programs and implement technology into clinical settings, but failure to fully evaluate the nursing work environment is one of the leading causes of failed implementations.

Informatics in nursing focuses on the information flow needed to provide nursing care. Nursing informatics is needed to bridge the "techs" with the nurses.

Just ask any informatics nurse who has had to implement a system that was initially led by only programmers, who waited until the end to ask nurses how they will actually use the system. I have seen a particular implementation be completely unused because it was designed without the nurses workflow in mind.

Regardless of the angle used to argue these points, it is the truth BCRNA, and I can attest to it!

Info(RN)matics · Feb 3, 2014

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.

That's interesting, llg - I never thought of it that way!

Whether Nursing Informatics is Nursing or not depends on the approach each Informatics Nurse has towards her/his job - is that the gist of your doctoral dissertation thesis statement?

llg, PhD, RN · Feb 3, 2014

That's interesting, llg - I never thought of it that way!
Whether Nursing Informatics is Nursing or not depends on the approach each Informatics Nurse has towards her/his job - is that the gist of your doctoral dissertation thesis statement?

Yes. The term "perspective" refers to both the angle that one views a situation from and also the lens through which someone looks. So ... if someone looks at a situation from a nursing perspective (using nursing philosophy, theory, nursing cultural norms, etc.), that person can incorporate informatics knowledge into their nursing practice -- in other words, still be practicing nursing as they are "doing" nursing informatics.

But ... if a person comes from an informatics perspective (informatics philosophy, theory, ethos, etc.) and is simply using an informatics perspective to address a situation that just happens to be nursing (but could be something else) ... then that person is really practicing informatics, not nursing.

It's a continuum. To what extent does the person use a nursing perspective and to what extent do they rely on an informatics perspective? That's the key. I have known people in Nursing Informatics who were/are definitely practicing nursing -- using informatics knowledge/skill while they approached the situation as a nurse. I have known others who were barely nurses -- if they could be called nurses at all -- for whom the fact that this was a nursing situation was just incidental. The situation could have been in any context to them as they did not come from a nursing perspective at all. Nothing about them or their actions reflected nursing.

Info(RN)matics · Feb 4, 2014

Yes. The term "perspective" refers to both the angle that one views a situation from and also the lens through which someone looks. So ... if someone looks at a situation from a nursing perspective (using nursing philosophy, theory, nursing cultural norms, etc.), that person can incorporate informatics knowledge into their nursing practice -- in other words, still be practicing nursing as they are "doing" nursing informatics.

Thank you for the response, llg! Perspectives are indeed 'ways of seeing,' and are influenced by background and experience.

Won't all nurses with some clinical experience come from a nursing perspective then?

Have you seen some informatics nurses move on to use some other framework, and then refuse to use a nursing perspective altogether?

llg, PhD, RN · Feb 4, 2014

Thank you for the response, llg! Perspectives are indeed 'ways of seeing,' and are influenced by background and experience.
Won't all nurses with some clinical experience come from a nursing perspective then?
Have you seen some informatics nurses move on to use some other framework, and then refuse to use a nursing perspective altogether?

Some nurses "fall in love" with the perspectives of other disciplines as they become deeply involved with them through graduate school, work, peer relationships with people in those other disciplines, etc. For example, some nurses who get MBA's and go into Administration start relating so much to the business side of healthcare that they seem to forget their nursing roots. (Others don't forget their roots, of course.) Similarly, the same thing can happen with Nurse Practitioners, who become so enamored with the "medical model" that they start to "put down" the very nurses they used to work with -- but others don't, of course.

It can happen to anyone who felt the direct-care was "not a good fit for them" and who then got a graduate degree in another field (or in specialty with a lot of content from another discipline.) They feel more comfortable with the content of that other field and start identifying more with that other field than do with the average nurse. Their sense of identity and their perspective become increasingly that of the other field and less and less that of nursing. As I said, it's a continuum of persective and professional identify -- not always clear cut.

Here is a question that helped me think through my dissertation:

Imagine 2 students both getting Master's Degrees. One is an Informatics student who has never been a nurse. The other is getting his/her MSN in Nursing Informatics after having been a nurse for many years -- and who has attended fine nursing schools that provided a strong foundation in nursing theory, research, history, culture, etc.

Both students choose to work on the same project for their Master's thesis. How will those theses differ? Will the perspective of the 2 students be different? Will their approaches? Theoretical foundations? etc. How will the foundations of the 2 students' education and experience influence their projects? Should they be identical or should they be different?

The thesis of the Informatics student should further the development of knowledge in Informatics. The thesis of the Nursing student should further the development of Nursing knowledge. They should be coming from different disciplinary perspectives -- and that should be evident in their projects. Think about how that would show up in their projects.

If Nursing Informatics is going to be a considered a nursing specialty, then they need to be different -- and people getting graduate degrees in Nursing Informatics should know how and why they should be different.

Thanks for the thread. It's been fun for me to re-visit this topic that once consumed so much of my time and attention.

:geek:

Info(RN)matics · Feb 5, 2014

If Nursing Informatics is going to be a considered a nursing specialty, then they need to be different -- and people getting graduate degrees in Nursing Informatics should know how and why they should be different.

Thank you llg - I understand your point better now :)

I am not sure if it is considered appropriate, but I'd like to ask you - can I read your dissertation? I may not be able to read it right away - but I'd consider myself privileged to be able to take a look at it.

Let me know :)

llg, PhD, RN · Feb 5, 2014

Info(RN)matics: Check your private mail. I'll answer your request there.

llg

ArmyRN789 · Mar 18, 2014

That is alot to read. I can tell you from the Army's standpoint, they are starting to move away from placing nurse informaticists in the Dept of Nursing due to the fact that this limits their capabilities. They remain a nursing asset and can't really delve into other arenas such as outpatient clinics and physician workflow, etc. They have become smarter and have begun placing them in the Information Management Dept which opens up their scope to the entire facility. They are becoming CMIO's of their facilities. They tried having CNIO's and then making a physician the CMIO, but it didn't work out because there was too much redundancy. Nurse informaticists no longer work with just nurses, but it's their clinical experience as nurses that give them their unique insight. We can also be MUCH cheaper CMIO's! Think of it as sorta like Nurse Practitioners. They can now do just about anything physicians can do (especially since it's now a Doctoral program!), but are much cheaper to hire! Is NP no longer a nursing specialty now that it's a doctoral program? Not exactly the same, but you catch my drift.