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Discussion

Learning EMR

Made it through one week of my new job! It's going great. Everyone is so nice and I'm getting to go super slow to learn everything.

My biggest fear was being inadequate at assessing and diagnosing. I am still concerned about that but it has gone on the back burner to learning the EMR system. It is so stressful! Thank goodness, I am getting all the time I need to learn it but sometimes my mind just goes blank and I don't know what to 'click' next.

It's super stressful having to learn this system on top of trying to care for the patient also. I will probably be turned loose to do a few patients on my own next week and I am so nervous.

Plus, my position is a float nurse to several different rural clinics. The first thirty days I get to stay put in one place to get the initial orientation with a doctor thing completed but after that I will be traveling so my body will have to adjust to that.

Luckily, I have been following a FNP that I was in the NP program with. She was an ANP and went back to get her FNP so I already know her and I am comfortable with her.

Anyway, rambling again! Just wondering, do most of you do EMR or paper charting?I think EMR is best in the long run but it is hard! Any tips on getting used to it?

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    • Guides

    My clinic is 100% EMR. We use the Next-Gen system, which is not the most user friendly system out there. The only way I got comfortable with it was to use it. I still find it a challenge to talk with a patient and type at the same time-I try to enter just enough info so I can come back to it later and know what I did. I made cheat sheets at first so I could at least stumble around without getting too lost. It will come with time. Try and do as much charting as you can when there's someone else around, so you can ask questions. Eventually it will be second nature.

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    • Experts

    LOL

    I'm credentialled at five hospitals with four different EMR systems:

    McKesson Portal

    Epic

    Another type of McKesson Portal

    Hospital hybrid system

    And....then our practice has yet another EMR: Acumen

    Had to laugh about your frustration - try it with five different systems!

    I'm fairly computer literate and was a journalist in the military prior to becoming a nurse 20 years ago so my typing is pretty good.

    That would be my best advice - learn to touch type so that you can type while talking/looking at the pt. Otherwise, with the numbers of pts you are expected to see a day (I work in nephrology and see dialysis pts) its going to make it harder on you.

    Enlist a colleague's help to set up "smart phrases" or whatever they are called so that you have a template set up that you can then cut and paste, learn all the ins and outs of the system - this will help so much.

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    I use three, one EMR (VA-CPRS), one combined (transitioning-pilot). Practicefusion is our current pilot and EVERYone seems to LOVE it, including billing. I use CPRS almost daily and Practicefusion on weekends, occasionally during the week for a few hours, both are very similar.

    Once you get used to templates and E-Rx, you'll wonder why in the world you ever used paper. Templates are a blessing. You can customize, according to your needs and major system/practice/population, etc. Just don't get too lazy and forget that not everyone fits into a template mold.

    I usually make my students begin on paper, forcing them to think, then let them transition to a template, encouraging them to create their own, hoping to stimulate a few brain cells. Most are very receptive and understand why I do this. I actually pick up on new updates/clinical issues this way! I've even had their instructors give positive feedback.

    Sometimes, printing out the default template and using it as a note/cheatsheet is ideal, esp if you move around a lot or work in a very busy clinic (urgent care, ED, ICU, etc.) I also have the students do this, it helps them/me during discussion of the A/P.

    All you need is time, if it is web-based, as Practicefusion is, practice some at home on the fake patients. Best of luck! :up:

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    • Experts

    Forgot about e prescribing. it's absolutely wondeful.

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    Do you still use NextGen?

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    • Guides

    No,I left that job a few years ago. I now use Epic (which I love) and eClinicalworks.

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