Nurses Step to the Front
In hamlets and high-tech hospitals, nurses are taking on bigger roles
Nurses are also walking the cutting edge of health technology. They are at the vanguard in shifting hospitals away from mountains of problematic paper patient charts to automated, computer-based systems that cut down on de-lays and errors, says Scott Young, director of health information technology at the federal Agency for Health Research and Quality. About an hour south of Pittsburgh at Uniontown Hospital, Chief Nursing Officer Rebecca Ambrosini is one of those pioneers. Tired of 40-plus-page medical charts that "were never where we needed them when we needed them," she helped make a monumental change. After two years of work, nearly 85 percent of Uniontown's patient information is now available in a user-friendly desktop program called PowerChart. Only about 13 percent of U.S. hospitals have done anything like this.
The Uniontown system not only records patients' vital stats, like allergies and blood pressure, but also automatically sends doctors' orders to nurses, organizes reminders on necessary lab work, and sets up schedules free of hassles like double booking. The program also fires off automatic requests for help from social workers and even interpreters if one is needed. "Before, you had to pick up a phone and call for this assistance--if you remembered," says Darlene Ferguson, a critical-care nurse who is now Uniontown's director of clinical informatics and runs the system on a day-to-day basis. "We would grab a paper towel, write down what we needed, and stuff it in a pocket."
New ventures. At first, this high-tech onslaught made some Uniontown nurses a little nervous. "Some people talked about quitting" because they were worried about using computers, says registered nurse Donna Martin. But Ambrosini and Ferguson ran hours of workshops to get everyone up to speed. Now, wireless PowerChart workstations on wheels line the beige hallways at the 230-bed facility. Nurses roll the computers into patients' rooms to take information and update charts with a keyboard and mouse rather than paper and pencil. There also are computer stations that are built into the walls and fold up like Murphy beds.
Nurses are also gaining ground in one of the fastest-growing areas of medical practice: genetics. According to Grady, of the nursing research institute, it makes sense for nurses to be involved in this fast-moving field because while genes may put patients at risk for health problems, changes in lifestyle and habits--a topic close to nurses' hearts--can help mitigate them. One recipient of the institute's funding is Lorraine Frazier, who holds a doctorate in nursing, a postdoc in genetics, and a teaching position at the University of Texas at Houston College of Nursing. Several years ago, when she first told a molecular medicine researcher that she wanted to work with him, "he was surprised," she says. "No nurse had ever asked to do that. Then, he asked me what nurses do." Now he knows. Frazier runs studies looking at how genetics shape the risks faced by patients with unstable heart disease; the results will eventually help tailor treatments for these patients.
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