Eishouse

Thanks - This is exciting! I'll let you know how things work out.

Re: Entry level jobs in informatics Thank you EileenRN for your input. Yes, I am looking at the bridge program at Walden. I have just finished statistics,which was my only gen ed class and now have to decide which program path I am going pursue. If you don't mind sharing, how did you get into the field? My arrival in the field happened because I stomped into IS demanding to know who had made such a mess of our charting. This was 7 years ago. Nobody in the facility was willing to say the "Informatics" word until last year. They gave me a cubicle, a few photocopied pages from the System Administrator's handbook, changed my access from RN to System Administrator, and told me to figure it out, and to call McKesson if I had any questions. They called me a Clinical Systems Coordinator and put me on a bunch of committees. After I discovered McKesson's Download Central site, I got all the manuals I needed, including training manuals.That happened right after I rewrote the training manuals we had because they didn't make sense.The department had a lot of potlucks and were pretty friendly in general, but nobody knew anthing about my system, so I practiced trial and error, building charting screens, designing reports, fixing the parts I had come to complain about, and getting the complaints from the whole house. That's kind of how it's been the last seven years.

Re: Who is responsible for discussing End-of-Life Treatment Options My most difficult experience with this situation was not one I could handle as a nurse, although there have been many times I would discuss with the family, then discuss with the doctor, then back to family, back to doctor, until they were able to come to an understanding. My father was the patient, his doctor, just a few years younger, had put him on his first blood pressure medication decades ago, and had see him through meningitis, a few broken bones, and all the ravages of heart disease. As I was the medical professional in the family, my dad would tell me what he wanted and expect me to deal with it. My mother, in the early stages of Alzheimer's Disease, wanted everything done for him; she wasn't prepared to give him up without a fight. The doctor, who saw my dad as one of the patients who had stood by him since he started practicing medicine, just knew that dad would rally and we would not have to talk about this. My father, wise man that he was, refused to go to the hospital again. He died in his sleep, in his own bed, in his favorite pajamas. That's what he wanted. I wish I could claim credit for making it happen like that. I do have the satisfaction of knowing he got what he wanted. I believe there's a special place in heaven for people who have died peacefully in their own beds, almost like they had completed their earthly projects, so could rest until they died.

Hi, - Good subject to look into. I have a couple of stories about nurses making medication errors, if that's the sort of error you are looking for. The first is a med error discovered by the finance department's nurse auditors. The RN on the floor had apparently been trying to administer a dose of a q6H antibiotic along with the morning med pass (0800).She got an error message stating that the administration was too early. She overrode the warning and gave the medication anyway, adding a note to the MAR which read, "This damned computer doesn't want me to give this medication." The antibiotic was on a 05-11-17-23 schedule, so she was determined to give the medication either three hours early or three hours late. She didn't have time to check the medication schedule because she had to have time to write a note explaining that the damned computer was causing the entire problem. It never once occurred to her that she should listen to the alert and figure out what it meant. There was just no way that error was caused by anything but the damned computer. I don't know if stories of this nature are what you are looking for, but if this one works for your project, I'll tell you some more. I'm the Informatics nurse at my hospital, and believe me, the war between technology and nursing is not over.

Hi, FlyNavyRN -I spent 2 years watching my husband get a MBA from U of Phoenix before I started back to school. He spent each 5 week term in agony, sometimes staying up until 2 AM to finish school work, then getting up at 5 to go to work at 6.The good news is : He did it! and the good news for me: I found Walden - longer classes, less expensive and so far I have been impressed with the professionalism of the instructors and fellow students. I might add I am also learning quite a bit of new information:specs: And no marathon writing sessions.

I've been keeping tabs on the TIGER initiative, too. What a great thing for nursing! I would love to be a participant. Does anyone know how to make that happen?

Hi RN in the D, I love this site, too. You sound like a great Informatics nurse in the making! Are you looking at one of the bridge MSN programs that let you skip the BSN? I'm enrolled at Walden University, one class short of finishing the first year. Then I have 1 year of core curriculum for MSN students, and then a year in the Informatics specialty classes. It has been great so far, and I'm doing well. I hadn't been in school in 26 years when I started, so was a little worried about my ability to keep up, but I haven't had any problems. In terms of credentials, I think the MSN is always more valuable, although getting the Informatics certification is also a big deal. I do think the MSN gives you more diverse opportunities. I don't think you will miss the boat - Healthcare Info Tech is growing exponentially, and will not ever go away. There is a great need for clinicians and critical thinkers to keep the industry focused on what matters - the best outcome for the patient. I wish you the best with whichever path you choose.

Hi, bknyrn - You should expect to be paid similarly to clinicians. If you had an Informatics certification or MSN with Informatics specialty, you should expect to be paid similarly to Clinical Specialists.

I have lived in Casper and worked at Wyoming Medical Center for 11 years. It is definitely one of the best facilities I have worked in. The CEO is an RN, which puts some caring into management. WMC serves as a clinical area for nursing students from CC and UW, as well as a Family Practice Residency for physicians. It is a Level 2 Trauma Center, working on getting to Level 1. I don't like the public school system, but haven't had kids in school for the last few years, so my opinion is outdated. Casper College is fairly diverse and includes a University of Wyoming campus with several Bachelor's and a few Master's degrees available. In Casper, we have Casper Mountain (skiing), the Platte river (great fishing), sand dunes, grassland, and Alcova Lake (boating) all within 30 miles. We have a small but good symphony orchestra, a great community theater, a wonderful art museum, a great community rec center with swimming and ice skating, a MLB farm team, and many other entertainment venues. The only thing about the weather that I really hate is the wind. Other than that, Casper is a very decent place to live and work.

You are most definitely asking the right questions. You have also gotten good information back from your post. Having spent the last seven years of a 27-year career in nursing in the Informatics field, I have a few comments based on my experiences. First, clinical understanding is everything. If you are not an experienced and thoughtful clinician, you will be unable to support the practice of nursing through Informatics. In addition to clinical skills, you will need skills in politics, finance, education, leadership, complex problem solving, and decompression of hostility. You will also need skills that enable you to visualize, understand, and map workflow processes, as well as being able to facilitate change in those processes when necessary. You will need knowledge of nursing theory, nursing research, and formulation and application of Evidence-Based Practice. You will need familiarity with CMS and Joint Commission regulations, National Patient Safety Goals, Core Measure assessment points, and any other initiatives your hospital targets. You will need to understand how data becomes information, and how information becomes knowledge. You will use all of these skills daily in creating and launching documentation that supports nursing (or RT, PT, Dietary, Pastoral, etc.) practice and provides data-driven decision support, and documentation that targets specific pieces of information that can later be retrieved by query (or input designed to produce specific output). You will spend a lot of time defending nursing to IT professionals who don't understand clinical situations, and to defending Info Services to clinicians who don't like or want computers in their workplace. You will need to understand and explain the dynamics of change to people who don't want to change. You will be a leader in the change process. You will be a liaison between nursing and IT, nursing and Nursing Admin, Nursing Admin and Finance, and many other groupings. When you narrow it down, the three people you need to be are: 1. Nurse 2. Teacher 3. Politician. Good luck!