Transition to electronic medical records

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Specializes in Rehab.

How much training did you get for the transition? We will be going live in about six weeks with our EMR and training started two weeks ago. The nurses will have 16 hours of in class training by the time we are up and running. The most difficult part of the process is that we are recieving training, but the system is not completed yet. We have checklists that we are to complete (saying that we have completed the training), but are not able to, and to our knowledge there is no plan to train us on those areas once they are completed. The response we keep getting is that we just need to go onto the system and practice, and keep trying the different applications to see if they are available (we are supposed to do this during work hours while we have our regular assignments). Does this sound like any of your experiences? Any tips or suggestions that might help will be appreciated.

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Specializes in Nurse Scientist-Research.

We had tons of training. Sadly it was general training and I am in a very specialized area. So we were told to just try to get the information into the computer flowsheets. We did all right, eventually. Joint Commission had a few things to say when they visited and we got some retraining then (thankfully no one came down on nursing for that, they got it that we were never presented with the information in the first place).

One really fabulous part of the transition was the "death" of the written order. Virtually all MD orders are computer entered (vast majority being done by the actual physician). No more gatherings of nurses trying to decipher ancient sanskit. No more discussions with lab or radiology trying to figure out if the doctor really wanted this send-out test that's rarely done or a rare radiology procedure and if he/she does, then can I call him/her and get an order for the 12 part prep required. You know what I'm saying.

Truth is, the transition is painful, but I agree with those who have said it just requires practice with the live program. If your facility offers you the chance to practice in a test environment, do it, it will be worth your time. Be warned though that some programs do not work the same in the test environment as they do in the live clinical environment.

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Specializes in home health, dialysis, others.

You can never have enough training - and 16 hours does NOT seem like very much at all. Further, they need to bring in as much help as they can for 2-3 WEEKS so you all have time to get up to speed. You will not be able to carry the same number of pts as usual while you are mastering the system.

And keep in mind, that EMR is good for 3 main things - Billing, billing and billing.

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Specializes in Critical Care.

That's about the same amount of training time we got. They did upstaff for the first couple of weeks but once we started playing with the system, it wasn't that hard. And it's actually made the job easier, IMHO. No more chasing down charts with orders missed for hours. We do have some nurses who refuse to check their orders per protocol and then stuff gets missed that way. But it's easier for mgt to f/u with those people specifically (as it should be handled) instead of trying to figure out who may have missed what. I like the fact also of not having to decipher orders, huge plus in my book. It may not be as bad as you think, it wasn't on our end.

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Specializes in Rehab.

I agree that it will definately be better in the long run, and I am actually looking foreward to EMR. I guess that I am more frustrated with the fact that we are supposed to go live in 6 weeks and entire units have nothing built to learn and practice with. I do not understand why this is being rushed so much. Why not complete the program and then train staff.

I have every intention of practicing as much as my work load allows until the go live date, but I am really worried that other staff won't. As the charge nurse I have been trying for over a year to encourage staff to at least get comfortable with a computer to help with the transition and most of the nurses who have been here for years absolutely refused to touch them. I guess they won't have a choice now.

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Specializes in Health Information Management.
I agree that it will definately be better in the long run, and I am actually looking foreward to EMR. I guess that I am more frustrated with the fact that we are supposed to go live in 6 weeks and entire units have nothing built to learn and practice with. I do not understand why this is being rushed so much. Why not complete the program and then train staff.

I have every intention of practicing as much as my work load allows until the go live date, but I am really worried that other staff won't. As the charge nurse I have been trying for over a year to encourage staff to at least get comfortable with a computer to help with the transition and most of the nurses who have been here for years absolutely refused to touch them. I guess they won't have a choice now.

As to your first point...agreed. It seems like a very goofy way to train people. The hours allotted don't sound bad, but good lord, training people when they can't actively use the system sounds pretty stupid to me. Some people are incredibly hesitant about trying new computer programs on their own, so organized training with a fully active system seems like a must. Perhaps you could try to band together with nurses from other units and push with a unified front for additional (or rescheduled) classroom training time once the previously unavailable system aspects are up and running?

As for the nurses who won't touch computers - any particular educational background or age group?

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Specializes in Rehab.

The nurses who don't want anything to do with computers are mostly in the 45 year and up range and mostly LPN's (but that may just be because we have a higher number of LPN's compared to RN's). I understand that it was not part of their education and for some it is entirely foreign, but I really feel that a basic computer course should have been offered to anyone who wanted it prior to starting the EMR project.

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Specializes in Nurse Scientist-Research.
I really feel that a basic computer course should have been offered to anyone who wanted it prior to starting the EMR project.

I saw this as a real challenge for some nurses. We had some nurses that have never owned their own computer so even moving the mouse was a challenge. Some of these folks didn't even have basic typing skills. Think about it, where would most of our typing skills be if we didn't use our computers so extensively.

In another job (that used computer charting) I remember a nurse literally typing hunt and peck for all her computer charting. Not only did she not grow up with computers, English was her second language, charting was really tough on her.

Having said all this, I am still overall a fan of EMR.

You know, truthfully, from all I've heard in person and from this site, no hospital is ever "ready" to go to EMR. They put it off until they meet some deadline and the training is never sufficient, and we nurses somehow all make it work in the end. And when we don't do things right, trust me, the hospital will get around to telling you about it, eventually, maybe a year or two down the road. . .

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