The pandemic has pushed nurses to the limit. A recent survey by the American Nurses Association reports that 51% of nurses feel overwhelmed, 76% report exhaustion and exhaustion, and nurse-to-patient workloads have tripled. (January 2021). Hospitals operate on the backs of nurses and current levels of exhaustion cannot be maintained.
In addition to the pandemic, electronic health record (EHR) systems share much of the blame. EHRs were introduced into the healthcare ecosystem to streamline document workflows and facilitate the exchange of patient information. But EHR systems they have fallen far short of their promise, causing stress and exhaustion from the doctor and less time for interaction with patients. In a 2019 JAMA surveymore than half of the problems associated with physician stress and exhaustion resulted from inefficient EHR systems.
Problems with the design and use of EHR, such as information overload, excessive data entry, swelling of notes, inability to navigate the system quickly, and the fear of missing something, were listed as some of the main reasons for the “high stress of the doctor”. In addition to 12-hour shifts, nurses often need to spend an extra hour or more completing non-intuitive shift change documentation.
While doctors see patients for minutes, nurses see them for days. In addition to providing care, her responsibilities include monitoring, preparing the patient for procedures and movements, and educating the family about what is going on. It is a debilitating job, even more difficult because of the masks that disrupt nonverbal and emotional communication. This can make patients not feel “lived” and tin will be reflected in the decrease in HCAHP scores.
A walk through any large hospital will immediately show how dramatic this trend has been over the last decade. Nursing used to be a career in which most stayed between 20 and 30 years old, often in the same facility. It is now more like 3-4 years old. Nurses simply have more opportunities today and can continue their training to earn more or leave hospital positions to work in alternative companies, such as an insurance organization or a municipality.
The use of itinerant nurses can help with short-term nursing shortages, but incurs additional costs for the hospital system. The pandemic has helped increase the use of this resource due to declining availability of nursing staff and provides an alternative route for nurses outside the traditional employment model, which can further negatively affect the system already. stressed out.
Nursing responsibilities continue to increase, further complicating the problem. On the 21stst The Healing Act of the Century requires that patients have unrestricted access to their medical records. Browsing the maze of lab and image reports and doctor notes with current technology is a daunting task for patients. Inevitably, nurses will be asked to help patients and family members understand how to access information.
Unless these issues are successfully addressed, the exhaustion of nurses will continue and worsen. Although there are problems, the technology offers some solutions.
Better healthcare computing Requiring less time with the EHR, and more time by the bedside, should significantly reduce crushing workloads. It will also support remote patient follow-up (RPM) of patients with chronic illnesses. This will allow the development of virtual care, which will further improve the ability of providers to extend and improve care to at-risk populations, deliver better outcomes for patients, and improve the profitability of the healthcare system. Nurses will play a key role.
Population health efforts driven by better data and analysis can also focus efforts on high-cost patient care, making the best use of health resources. As the backbone of the hospital system, nurses will also be critical in this area.
Nurses are not against technology, but will adopt a new set of tools that will create a more rewarding experience, reduce stress, and allow them to do what they do best: re-establish the nurse-patient relationship that is so critical. . to positive results. I am encouraged by a new and evolving partnership between hospitals and healthcare technology, which has begun to appreciate the magnitude of the problem of nursing exhaustion.
HIT innovation has the potential to ultimately deliver end-user convenience and process the efficiencies it has demonstrated in so many other industries. Otherwise, the status quo will not be maintained and nurses will continue to pay the price.
About Dr. John M. Cicco
Dr. John M. Ciccone is the medical director of DSS, Inc.. A practicing cardiologist since 1982 and a leading advocate of better IT for health, Dr. Ciccone began his career in New Jersey and moved to South Carolina in 2012. He is Board Certified in Internal Medicine, Cardiovascular Disease and has additional Board Certification in Integrative and Holistic Medicine. .