As I sat on the couch in my patient's home, I could feel my computer drawing all the attention in its direction. Like some irresistible force, it seemed to lasso and pull away the family's eyes. I deliberately moved it to the side, setting it where I could still see it, but where it would not be a barrier between me and my patient and her family. I proceeded with the questions related to the admission, laying a hand gently on my patient's wrist, taking her pulse as we talked about her medical history. Ah, the computer! Blessing or curse? Many electronic medical records (EMRs) are more in the latter category at this time, but over the years, they should continue to evolve so that they look more like they were destined to be: easy connectors and infallible memory banks. Yes, they are here to stay. Complaining and arguing and fighting against them does all of us a disservice. Instead of railing against what will truly become wonderful progress in the field of medicine, let us as nurses find ways to make computers assume their correct place in the nurse/patient relationship: as tools to be mastered, servants to the job at hand. For those who knew nursing before the advent of computer, fear of change can be a destructive force, holding us back from rising to new challenges. But for all of us, the shear volume of documentation in the medical world can distract us from the centrality of the relationship with the patient- our most valuable work and truly the essence of nursing. Whether in an outpatient setting, doctor's office or hospital, we all currently work with computers or will in the near future. When we become completely comfortable and proficient with our EMRs, then the computer assumes its rightful place in the nurse/patient relationship-one more piece in our patient care puzzle. With fluency and complete ease of use, the program ceases to be master and becomes servant, sliding away from the part of our mind that triggers stress and into the more automatic response area-a chore to be done. But first, we must jump over the hurdles that keep us from settling in to learn it well. As we use EMRs, the question becomes, how do we maintain our ability to be compassionate nurses while also keeping in step with the required documentation? How do we gracefully marry our professionalism with our humanity? Gone forever is the nurse in the white cap and starched uniform (no nostalgia here for that!), but we can all feel the danger posed by these little lighted boxes that we use all day, every day, demanding machines that require inordinate amounts of careful attention. Even if the old ways are gone, how can we continue to adapt well, nurturing our relationships with our patients while also documenting? Here are some possible tips to consider. Feel free to add more of your own or comment on what works well for you: Connection Counts When possible, begin and end your encounter with a contact with the patient. In hospice, I like to try to shake hands and learn names and relationships. This opens the door to questions and sets the stage for open communication. Even if the patient is unresponsive, I feel it is important to say their name, maybe touch their shoulder, and let them know that I will be talking with their family for a time and asking some questions. Set Up For Success Be deliberate about how you position your machine. Don't let it take center stage. Try to angle your body toward the patient. When talking or listening, take your hands off the machine and try to assume a receptive posture (uncrossed legs and arms, palms open and turned up, if possible). Save It With some EMRs, it is possible to make notes and return to the screen to flesh out details later. If not, explain that you are going to type in some details before you turn to face the screen again. Listen Well Don't let the computer become the patient. As competent professionals, let's keep our eyes focused on what matters. Let's listen carefully to our patient's story. Let's not forego the gentle touch on the hand, the cool cloth to the fevered brow, the extra warm blanket, the ice chips on the parched lips. Stay Positive Working together to cultivate a positive attitude about the EMR and what it has the potential to do for us in medicine can pay off big dividends. Sometimes our default setting is called "complain," but we all know that this does little to help us move along constructively toward our goal: outstanding care for each and every patient with fewer mistakes and better communication. Some EMRs are definitely better than others, but all have pluses and minuses. Finding ways to work around the negatives can help us all get through these years of adjustment. As the visit closed, I pushed the lid down on the computer and slid it into its bag before turning back to the patient to answer a final question about our scheduled return. I squeezed her hand and told her how much I appreciated this opportunity to talk with her and to get to know her and her family, closing the visit with a decidedly human touch.