The public view of nurses as subordinates to physicians, simply “trained” to follow doctors’ orders, an overall lack of understanding as to the level of education and the kind of work nurses actually do (Sullivan, 2004) has lent to this perception. Sullivan (2004) writes about telling nursing’s story as an avenue to turn opinions around; empower nurses at an individual level, and ultimately raise the bar to a degree where nursing as a whole takes a stance to being viewed and treated as experts in the health care arena alongside other disciplines.
Nurses outnumber all other health care providers (Kelly & Crawford, 2008, p. ) in both acute care and community care settings; are the most diverse clinicians having knowledge and experience that intertwines with all other health professionals, the public and now the business world. Nurses collectively have a deeper understanding of the everyday goings-on within all areas of healthcare. The challenge is to convince those who do not recognize this attribute to tap into an invaluable resource.
The message I have chosen to include in this paper will attempt to encourage and support the utilization of nurses in the area of clinical informatics, as this is an up-and-coming opportunity to recruit the experts.
Deciding on My Message I have always had an interest in computers long before I went into nursing. As a new graduate nurse in the early 1990’s I went straight to San Antonio, Texas where at one of the hospitals I worked implemented a cutting-edge clinical documentation application in the intensive care units. I quickly became a champion user as I was quite comfortable with the whole concept. That, blended with my diverse clinical experience in nursing to include using many other applications in various areas set the stage for my area of expertise; clinical informatics.
As a practitioner, I felt unfulfilled at the bedside, frustrated with the lack of positive recognition toward the profession, regardless of the root cause. Being able to move away from direct patient care to a role that required a strong clinical background, informatics became my passion. My concern has intensified over the lack of clinicians called upon to do what nurses do best: clinical workflow analysis, agents of clinical change management and clinical adoption, and most important ensuring the application is robust enough for that program, clinic or unit based on expertise in that area.
The further I observe resistance to change and poor adoption by nursing the more incensed I become with the lack of expert utilization. The motives for the resistance are significant: the omission of the nursing process, the inability to enter orders (physician and nursing), track medication and document medication administration is to list a few. These gaps could have been identified and possibly avoided had nurses been involved in the initial requirements gathering.
Nurses understand process and know what questions to ask, as opposed to non-clinical analysts, who could not know what they do not know; who better to understand specific practice methodology and process than those who live it? Furthermore, physicians are viewed as the key holders to patient care while nursing and other allied health groups are seen as simply assisting the physician, not as part of an integrated multidisciplinary team. Nurses understand and embrace this model far more than other disciplines and are the best choice in this domain.
Deciding on How to Share My Message The conduit for my message is through networking with individuals I have met and worked with over the years with influence and power; those at the executive level in the health region, university and college leaders, business leaders and clients, in person, via letters, and public speaking. Another channel I will utilize is the Canadian Nursing Association Journal with a letter to the editor or submission of an article to be published within the magazine.
The target audience at this time is business and other health care professionals as the need to have nurses recognized as assets to the fast moving execution of electronic systems in health care, soon to replace paper, is urgent. If more nurses are not involved in this process as expert consultants, there is a high risk of failure and inevitably patient safety. I will not directly target the public but indirectly as I believe once health care and business professionals view nurses as experts in our profession overall, then their perceptions and opinions will reach the public.
The obstacle will be persuading those with little health care understanding just how nursing can be affective. Business leaders are all about deliverables, making sure they are provided. How the product is packaged is not of great concern; patient safety is not a term truly understood by non-clinical analysts and project managers. Within eHealth in general, the organizational structure from top down holds minimal if any clinical knowledge beyond the high level business of healthcare.
The best way to convey the message in this arena is by example of competency and the successes when nurses are part of the team. Unfortunately, failed deliverables due to lack of clinical analysis and input is the other method of getting the message across in this instance. However, that would require a clear understanding of why the project failed, which has slowly been coming to light within the eHealth community. Therefore, the target for this message would be the CIO and the medical officer of eHealth, however, the argument must be well supported to ensure being heard.
As Kelly & Crawford (2008) discuss, the lack of awareness noted by the reluctance of nurses to be identified as experts creates an obstacle. Opportunities to speak at various forums that involve nursing directly or indirectly is the best way to share the message with nurses. I was recently asked to speak to an audience from the informatics graduate program at a university in order to encourage and promote more nurses into the program.
As one individual stated, “we recognize the unique expertise nurses bring to informatics and have identified the gap in this program. ” My Message In preparation for this assignment I learned that there are others in the profession that have identified similar trepidations around the lack of positive recognition toward nursing, however, a solid foundation to build on has been laid. As discussed in Sullivan (2004) nurses rarely take the opportunity to promote the profession through the media, citing shortage of time, or fear of repercussions as a motive to decline.
In order to be valued in positive locus those in the profession must promote their own successes without fear of appearing egocentric or as a braggart; taking pride in undertakings that might seem unremarkable but are more than that. While other professionals present their individual accomplishments regularly, gracefully accepting the prestige and standing that comes with their show, nurses must embrace this characteristic in order to continue paving the road to professional recognition. I am inspired to carry on promoting nursing as I have- by example, through networking.