stephenfnielsen

Can't help you out, but how did you like the program? Do you currently work in informatics?

If you have the guts for it, most places offer brutally honest feedback as to why you didn't get the job if they were willing to take you that far. If you ask with the right tact- honestly looking for feedback (not to complain or get another shot) it can be very helpful.

I left the ICU for informatics a couple years ago and it's been a wonderful move. It's an opportunity that won't come around very often to learn skills that a lot of other people out there covet. The way I see it, very few people have the body, let alone the patients to be a clinical nurse for a whole career so it's worth considering these moves sooner rather than later. Worst case scenario you don't like it or you're downsized and you go back to the OR.

You might try to hook up with a consulting firm that installs EMRs, they might be able to use you as a trainer. The reality is that nursing informatics is the marriage of clinical expertise technical knowledge, and project management skills. So you might ask yourself how you can beef up your resume such that it reflects the above. There is no easy way to do this, it takes time, networking and results. How would you start? Get a job in a hospital and tell you manager that as soon as the opportunity presents itself you would like to be a Super User for the EMR. From their start building relationships and looking for opportunities.

I'm sure there are snobby employers that only look at the school the applicant attended, but IT is a very results driven industry in general. "What you've done" is very much more impressive than what school you attend. So my philosophy is- get the degree because many times you can't get past HR without it, but focus more on beefing up a resume that speaks to accomplishments. I've never seen a mid-senior level position that says, "Masters required, no work experience needed". Jobs that are going to require a masters degree almost always require experience, so that would be my primary focus at this point.

Anyone who tells you it's a sure thing is probably trying to sell you something. That being said, the industry is growing at a phenomenal rate right now. I would foresee strong growth into the near future due to the complexities of current health reform initiatives and the shifting sands of reimbursement. It's somewhat counter intuitive, but right now hospitals are ramping up IT departments at the same time they are cutting back in other areas, historically IT is hit during times of belt tightening. The best thing you can do right now is become an expert at what you are doing and increase your skills in the areas of project management and training. If you can become a super user for your facilities EHR that will make entry that much easier. It really is a great field which offers a wonderful array of opportunities that you can take your career after you get your foot in the door.

It depends on whether or not this type of thing come naturally to you. I know a lot of people who can be in a crazy code environment and not feel stressed, but if you put them in front of a big group of people to present new ideas they freak out. If you like tech, project management, instructional design and working without clear instructions it might not be a stressful pathway for you. If you prefer to come to work knowing what is expected of you and being able to clock out at the end of the day this type of work might not be for you.

One thing to avoid is trying to turn Epic into an electronic version of your paper chart. People waste a lot of time and energy trying to do "what they've always done" instead of using the new electronic tools for what they are good for. Just because you used to have a particular flowsheet, does't mean that you now need an electronic version. I suggest using the model system as closely as possible (there are limitations) and work towards "best practice" documentation.

A few things that make it difficult: 1) A lot of programs make you take the whole year over if you fail a class (anything less than a C). This ends up creating $60,000 tests (if you fail you miss out on a year of RN wages). I don't care who you are, that puts pressure on you. 2) The fact that you can kill people when you make a mistake also makes nursing school more difficult. 3) And then there's the second guessing that goes on- it doesn't take a lot of time on the floor to realize that nursing isn't fun... don't get me wrong, I love nursing, but it is very hard work and is by no definition "fun" (at least for me). It makes you start wondering, "why am I busting my butt so hard for a career that I might not even like?" Notice- I didn't mention the subject matter of the courses; that's hard too, but not too much difference than the pre reqs. I think the biggest difference is that there's less grade inflation in the actual nursing program vs the pre reqs. Bottom line- if you are a person who is: a hard worker, somewhat smart, and has some mental and intestinal fortitude- you'll be successful.

Other areas away from the bedside might include: process improvement, education, risk management, project management...But if none of those appear, look to get on different committees that deal with change management within your hospital or see if you can become some kind of a super user for your unit.

Currently we report to IS (IT), previously we reported to nursing admin. In nursing informatics we live in both worlds and there have been pros and cons to being in both departments. We've received a greater level of technical trust reporting to IS, but have lost some of out contact with nursing leadership.

Don't take my advise as gospel, but you will find it very, very difficult to find work in that kind of field without previous health care leadership experience. Ask yourself- why would a hospital administrator want to give you a leadership position within the hospital when you have next to no experience in the field? All a degree like you are perusing will do for you is check a box on an application that says, "Requirements: MSN and 5-10 years of health care experience with progressive leadership responsibilities". If this type of thing is your goal, I would get a hospital job, spend a couple of years building up your experience while going to school part-time. By the time you finish your degree you'll be ready to apply for the type of jobs that you are considering. Best of luck!

The work is great if you can find it. There is that age old debate over whether you should go directly into a specialty or not. Generally people are referring to areas such as the various ICUs, L&D, OR and ED. From what I've picked up, the reason people say to avoid it, is because: 1) It's a bigger and more difficult transition and can lead to bad experiences (for yourself and your patients), 2) Since you didn't get the basic nursing care stuff (like basic skills and time management) down first, it can be hard to move out of a specialty if you find that you would prefer to do something else. It's up to you if you think those things are important. I went straight to the ICU and can say it was good for me, but not for a lot of other people. I'd say go for it if you can convince someone to give you a job, but generally, informatics jobs usually require a lot of experience because they want you to be a clinical subject matter expert and have leadership qualities. I went into the interview with two years experience as a CNA and a little over 1.5 years as an ICU RN and I can tell you there were definitely people on the panel that thought that wasn't enough. I think I was able to score points because I spent a year teaching at a charter school, volunteered as a Super User on my floor, and was involved in other leadership actives outside of work.

At least in my neck of the woods, a portfolio of experiences is much more impressive than any degree you have. Becoming a power user is a good idea and will help open doors, but also be on the lookout for leadership opportunities such are chairing committees that involve some degree of change management. Leadership/project management skills will make you golden.

It will be interesting to see where this goes. My facility has had the CMIO position come and go and currently has a CIO and a Chief Clinical Informatics Officer (currently an RN that reports to the CIO). I like the sound of the idea of a CNIO, but I'm not sure if that type of position would need to live at the executive level.

If you feel like this is really what you want to do and have an interest in moving to Salem Oregon you might want to check out the related job postings here. Salem Health | Welcome

It's all about physician buy-in. Do they want to do it? Are they excited about it? Probably not... and if that's the case, you need a few very strong personalities to be physician champions to put teen in butts. At the same time there needs to be ample support and they need to feel like the facility has their backs/are making it work for them/is responsive to their needs.

What do you want to do with all the training you have? What is your clinical background?

Epic is most definitely customizable, and most definitely has an ambulatory module (it was actually their bread and butter in the early days). In fact... I really don't know how Epic could be more customizable, they are known to build custom code for customers when their model system doesn't fit the bill. The reason why they encourage so strongly to stay close to their model is because if a system strays to far it can't use all their amazing training materiel out of the box. It's also true if you monkey around too much, future upgrades won't play nicely. Two features that I haven't heard of outside of the VA that Epic provides is their "Care Everywhere" and "Lucy" modules. Care Everywhere allows completely unaffiliated facilities to share patient information. Lucy gives a patient a repository for all their health information from any different Epic shop. Since so many level I trauma centers are going live with Epic, Care Everywhere becomes especially useful. We see a lot of patients going to OHSU for their specialty care, and return home for the rest, no more faxing/Fed Ex'ing records back and forth. Aside from the price tag I really can't see why anyone would be implementing anything but Epic right now.

Similar to you, I worked in the ICU as a Super User, and parleyed that into an informatics position. When I was hired into my new position my hospital had been live with Epic for about 5 years, but were staffing up a little so they could implement a few things to prepare for Meaningful Use. While rninformatics is correct about the shortage of IT staff, the problem is that everyone wants experience (unless they are in the implementation phase). If informatics is your goal I'd say to continue volunteering for as much it-esque opportunities as you can and if you are really feeling like a go-getter look into an MSN program with an informatics focus, although that's an expensive way to pad your resume. It's good work if you can find it.

I think it's funny that she has IT phobia. rninformatics has a good list there. If I were you I would look at what your career goals are and push your director accordingly. For example if you want to end up in education I would push for something that has "education" or "trainer" in the title. If you want to move more into the world of informatics something like "Orderset Analyst" or something that accentuates your implementation and project management skills.

Just this week there was a spread in the local paper about how the hospital I work for is 30 million under budgeted revenue right now, lots of belt tightening going on... but no plans to shrink the size of the IT department. There is definitely a huge focus on expanding that area right now.

It's a good thing, Epic is spreading like a virus so the more certs and experience you can get the better. I was there last week and I spoke with individuals from facilities that are moving from Cerner, Meditech, and McKesson to Epic. The other issue is that a great deal of the major hospital systems use Epic and they are gobbling up smaller hospitals and bringing them up on Epic.

Parity in LTC sounds intuitive. I'm always interested in how variable RN pay is across the country. New grads RNs in Oregon hospitals are now starting pretty consistently at $30/hr in hospitals, rural, urban, union/non, all pretty close. LTC it seems is around $24/hr.

Indeed this is very hard to believe, would you mind providing some stats? What state do you work in? How much did you start out at as an LPN? What hospital did your RN acquaintance work at? How much did s/he start out at? If nothing else I'm curious to know how hospital admin can possibly get away with it!