nungum

I am a C/S 5.65 site and have only been at this for 1.5 yrs but I was fortunate that my facility had hired a consultant for an ED project before I was hired, so I have been picking his brain this whole time. I can definitely share with you what I have learned because I know how frustrating it can be in the beginning and not know how things are supposed to work. And meditech training does not prepare you at all for real life scenarios. It's all just theory. Feel free to PM me with any specific questions. Marian

I was hired by the IT director and so report to her.

Hello everyone, Our facility will be implementing inpatient physician ordering and documentation this summer. It's a little premature but I just wanted to ask ahead to prepare myself for what to expect. For those of you who have experience with this, how was it like for you and your physicians with this new process? What were some of your obstacles and challenges. Any workflow issues? I am a Meditech C/S facility but I am open to any other non-Meditech as well since I'm sure overall, the workflow and issues may be quite similar to each other. Thanks in advance for any insights. Marian

Yayyy. Congrats!! I also just started an entry level position and I'm enjoying it a lot. So much to learn though. I wish I can fast forward to the day I feel comfortable with the system we are using which is Meditech. It's a very unsettling feeling to not be able to help with any issues that arises. Good luck with everything when you start!! :-)

Hi rninformatics, Thanks for the reply. I believe I will mostly be responsible for the PCS module. There's another clinical analyst there that is fairly new as well (1 year) but she deals mostly with the PHA module and doesn't know anything about PCS. That's why the IT director wanted someone with a nursing background to get involved and be the expert in PCS. According to the schedule, we will start implementing PCM end of next year and I will be involved in that as well. I'm pretty sure I won't be limited to just issues that staffing will have within PCS. My formal Meditech training will start Sep 27th in South Dakota. I love the autonomy of the position. Just not used to it quite yet. :-) Like yourself, my director stated she doesn't like to micromanage as well which is great. I just want to make efficient use of my time to learn what I need to learn so that I can get on board and be useful. I've already had a few people that I've met wanting me to work on certain issues they want me to work on. I'm all for being proactive and getting things done. I really want to excel in this position and be known as someone who is informative and can get issues resolved for everyone. I'm very excited and anxious to get past the learning curve. :-) I will be contacting the gal that was the go to meditech person for the hospital and setting up another session with her to get more specific details on what she knows about the PCS modules. Thanks again for all your input.

Hi Everyone, Just wanted to give an update on my new position. Just finished my 2nd week. So far so good, I think. The IT crew is awesome. Everyone gets along so well with each other. I'm thinking I will really enjoy this position but since I'm still in the training process and haven't really dived into the nitty gritty of my duties, I can't say 100% for sure yet. My official Meditech training isn't until the end of the month so right now, they have me just going in and playing around with the Meditech system. Luckily there is a consultant there that they hired before I came, to work on the ED portion. I've been learning from him a little bit about building the templates and using the dictionaries. He has to train a superuser from the ED on what he is doing so that she can take over after he leaves to be able to troubleshoot issues and any other requests made by the staff so I've been able to "tag" along. Other than that, I really have no idea what I'm supposed to be learning to excel in this position. I've navigated through the different modules in test mode and played around with the documentations. Looked through the Meditech website and browsed through their product knowledge base sections. The building using the dictionaries is so new to me (and very confusing). I'm thankful for the consultant who is exposing me to it. I've been focusing on that more past couple work days because he says it's almost the same as building on the PCS module. I'm understanding it a little bit more and more. I spent a lot of time going into one of the templates he was working on and breaking it down into the different sections and queries and answers. So I feel I'm getting the hang of the basics of building a template. I practiced building a section on the template he was working on and I pretty much got it except for the naming of the mnemonic for the section. I was thinking to myself if this consultant wasn't here, then I would be completely lost and would have no one really training me. I had a short session with the gal that was doing this role unofficially but we didn't get into anything specific. Just some of the assessment and care plan documentation process. She didn't even know what she was supposed to be working with me on. Stated she wasn't even a computer person and just sort of got thrown into the responsibility. It feels a little weird because I come in to work and am left to my own accord. I log on to my computer and just "play" and practice what I want. I ask questions when I need to but other than that, I need to figure out on my own what I need to be learning. Definitely not what I'm used to. :-) Can anyone else tell me if this is normal for this position or is it because there wasn't really an official informatics person at this hospital so that's why I'm not getting more of a 1:1 training? I'm just taking it a day at a time and telling myself that one day soon, I will eventually be knowledgeable about a lot of things and be able to troubleshoot issues for all the staff and implement projects. Any advice on what I should be focusing on? I asked my director if there was any one area I should start to dive in first to get a better feel for things but she said no and just to go "play" around.

Thanks ikarus7401. Once again I appreciate all your insightful feedback.

I will soon be in a nursing informatics position full time and was thinking about accepting a per diem position in my previous area of nursing (PACU) to keep up my clinical skills, if they offer me the job. First question: I know it's probably better to work at a different hospital but was wondering if it should be a different hospital that uses the same system as the one I will be working with (Meditech)or a different system(Epic). I'm thinking that getting exposed to a different system may be beneficial in that it can give me a different perspective, but then again, working with the same system will allow me to put myself in the end-users feet and therefore be more helpful?? Or maybe it doesn't matter at all? #2: Is any one solely doing nursing informatics full time and have you ever felt the need to be at the bedside throughout your NI career? Do others view you as less credible since you aren't at the bedside like they are? Thanks in advance for any input/comments :)

Hi rninformatics, I'm posting this message I sent to you via PM a couple weeks ago here since I'm not sure if you ever received it or not. I apologize if you have and just haven't had time to respond. But I would love to take you up on your offer for your old notes for the Meditech training. I will actually be going to South Dakota in September for the training since the next one in Boston isn't until November. It will be 3 days and the modules that are being covered are Patient Care System, Long Term Care Patient Care and Behavioral Health Patient Care. Not sure which version of Meditech it is but the platform is Client Server. Is that a version? Thank you ahead of time for your old notes. It would be extremely helpful. I hope they allow recording. How technical will the training get into? I guess once I review your notes I will have a better idea of the content that will be covered and will have more questions for you I'm sure. :)

I just wanted to say that I had my 2nd interview last week and just found out today that I got the job!!! :yeah: Yayyyy!!! I start in about 3 weeks and was told I will also be getting sent away for a few days for Meditech Training. I'm so excited and nervous at the same time. But I guess going into something you aren't experienced with is always nerve wrecking. Would reading up on Nursing Informatics in general help me out? I want to start immersing myself before I start working so I can expedite the training process. I know I will be here on a regular basis once I start because I'm sure I will have tons of questions. Thank you for all the support!!! :lol2:

So I contacted the IT director today and got a date for the next interview!! Next Thursday. It will be with the Director of Anesthesiology and the OB nurse who has been unofficially the go to person for their EMR's the past 3 years. I'm excited but yet so nervous just thinking about it. Wish me luck!!

BTW, what is an appropriate amount of time after an interview should I wait before contacting them for status updates? It has been exactly 2 weeks since the interview and 1 week since I was told a 2nd interview is being set up. Haven't heard anything otherwise. I'm anxious to start working to bring in income again so if I know for sure I didn't get the position, I can pursue other available options. I don't want to put applications in for different positions just in case I get interviewed and get offered the job. Other positions would be bedside nursing jobs. Also, is there a more correct way of approaching the IT director to ask about the status? Would it be appropriate for me to let her know that I would like to consider other options or would that look bad?

I've worked in 2 different PACU's and both have to call out ahead of time to make sure there is a spot and nurse available to take the patient. At 1 hospital, it was a strict 30 min heads up and then 5-10 min before arrival. A mini report was always given when the OR calls PACU for the heads up. The other place was a 5-10 min heads up. No mini report, just the doctors case and we would look through the OR list to see what patient it was and what surgery they had. Unless it was an ICU case, we would then find out if they had lines or special equipment we needed to prepare for. If there was no spots/RN's available, the OR would hold. The docs would be extremely mad when this happens but that's just the way it goes. Everyone tries to discharge/transfer as soon as they can and we even have the nurse managers come out to help to expedite the flow. I would hate to work in a PACU setting where the OR can bring out however many patients they wanted whenever they wanted. The max ratio is 2 patients to 1 nurses no matter what. Ratio is there for a reason. Anything beyond that calls for unsafe practices and will either harm the patient or one's nursing license. Just my 2 . Hopefully you can create some changes in your department for better and safer working conditions.

Wow, thank you so much for your input ikarus7401. I appreciate it very much. It's great to know that I can always come here to get support as I embark upon this new adventure in my career. I hope to one day have the wealth of knowledge in this area as well so that I will be able to pass it on. :-)

I remember when we went live with our bar code medication administration in the PACU, it was definitely a challenge. When we receive a patient right out of surgery, we require meds ASAP. We couldn't wait to have the orders scanned/faxed to pharmacy and then be able to access it in the accudose. On top of that, the EMAR scanning page was in a separate area so we had to get completely out of our assessments menu and into the EMAR so that was more time consuming. We were told that as long as our orders had a STAT sticker on it, then pharmacy staff would know to get those processed first. I don't think they were quite ready for the volume of orders that we were sending them because it was a constant hurdle between scanning, waiting, checking accudose for meds, not seeing it, calling pharmacy, waiting, checking accudose, still not seeing meds, waiting etc etc. Some meds we were able to just override and get out right away but we were discouraged to do that as much as possible. When you're giving multiple meds every 5 min while stabilizing a patient just out of surgery, it's nearly impossible to go to the EMAR page every time, scan the patient, then the med, then get a message saying meds need to be verified, then repeat the whole process again after verifying the meds, then finally able to give the meds. We pretty much had to just give the meds and write down the time and what we gave and go back later when we had a chance to document. That pretty much defeats the purpose of the EMAR. Overall it was a more time consuming task to do but of course like with anything else, all the bugs and frustrations were minimized over time and everyone got used to the flow of it. There were some things that couldn't be changed but we all just learned to accept and deal with it.

Oh, and also one other question. Are there any other questions besides work environment and level of support from superior that I can ask to help me determine if I will be supported in this role? I know it's a smaller hospital with more "older" physicians and nurses who aren't so computer savvy and may be very easily frustrated with new EMR changes. I understand that dealing with everyone's frustrations with EMR's comes with the territory for this position. During the interview, the director made a comment about how I should not tolerate any unnecessary or uncalled for remarks from the doctors. (Not that anyone should tolerate that behavior from any physicians in any department). I wonder though if this is a common occurrence and if I would be way over my head wanting to be employed at this smaller hospital 45 min away from my home, in an unfamiliar city, doing something I have no background in except my bedside nursing. I see this as a great opportunity for me to do something new and different with my nursing career and so far, I am quite excited about what this position entails. I can totally see myself in this position. I just hope I'm not missing any critical aspects to the position that will negatively impact how I feel about it. Thanks again for the input and any comments you may have for me.

Thank you ikarus7401 & rninformatics for your very helpful information. I've actually looked at and taken notes from both of the links you suggested for my first interview. I must say it was quite helpful. I remember 3 of her questions were the exact same questions that I had wrote down and reviewed. Questions were right on the $$. I'm guessing the interview went well since she wants to meet with me a 2nd time but with other interviewers. It just took me by surprise because I was expecting/hoping that I would find out that I either got the position or I didnt. Never been through a panel interview before so was just curious if there was something more that she didn't get the first time, or if there was anything else I needed to prepare for aside from all the interview info I've already gone through for the 1st interview? I'm thinking I should maybe prepare to answer more nursing related questions relating to computer charting since I will be meeting with other RN's and doctor?? Any clue?? And also, is it pretty normal to have multiple interviews for this position? Thanks again for all the input and I hope to return with some good news!! So far she's still trying to arrange a day/time that fits everyone's schedule so I haven't heard anything back regarding a date for the 2nd interview. Still crossing my fingers. :)

Hi Everyone! I interviewed for a clinical nurse informatics position at a smaller hospital about 1 1/2 weeks ago with the director of IT. I just found out that she is now trying to put together a 2nd interview but with a panel (RN's and a doctor). I have about 11 years of experience in various departments and hospitals, but no IT background. (I'm fortunate that they are willing to train me). I'm used to just needing to go through one interview and that was it. Can anyone give me any insight as to what I should prepare for? Thanks!!

Thanks anyways. :nuke:

I currently live in SF area but will be moving to Morgan Hill summer time. The closest hospitals that I would want to work at would be in SJ. If I were to commute from MH, it would take me 1 1/2 hr with no traffic each way. So if I could, I would rather not commute. I commuted for about 3 months and hated it. Any info about any PACU in SJ area would be helpful. Thanks :-)

Hi all. :-) I am looking to relocate to the SJ area and also to find a permanent PACU position that I can call my home. I currently work in PACU in the SF area and really like where I work. The staff and management is great, awesome hours (0630-1900 3 days a week), I work in different areas various days (ie, pre-op, childrens surgery, and then the adult PACU), no weekends, holidays, or nights for me. We do have mandatory on call weekend time but there are so many people here who want the OT that you never have to do on call if you don't want to. I just am not looking foward to the commute. Does anyone currently work in a PACU that they love. I'd love to hear more about your work environment and pros/cons of the place. Thanks :-D