EMR Charting: The Frustration of Duplication for Nurses

What kind of nerdy nurse would I be if I wasn’t an advocate of the newest nurse charting – Electronic Medical Records (EMR Charting)? Not worthy of my title, at the very least.

As a nerd, I am pretty much required to preach the glories of my geeky infatuations. Not only to justify my obsessions but also to promote more growth and innovation in the tech world. Us geeks need new tech to satisfy our cravings. A slight digression, yes, but you have no doubt grown accustomed to those in my little corner of the web. (And if not, you may want to start, because I can pretty much promise that they aren’t going away.)

I mention this to make it clear that I am a lover of technology. I am a promoter of early adaptation of new technologies and always excited to see what we will be able to do next that will simplify and improve our lives.

Nurse Charting With EMR – Electronic Medical Records

Nurse charting is so much easier with EMR, but What is EMR?

Basically, EMR is Electronic Medical Records. It uses technology to make nurse charting easier and more efficient.

Nursing and healthcare have benefited tremendously from the implementation of technology. Let’s take, for example, something small, routine at this point even: the vital sign machine. It alone, complete with pulse-oximetry, and digital thermometer are a huge time saver that aid in the prompt delivery of patient care. But I suppose most nurses don’t think about the fact that these innovations are a time saver and therefore allow you to have more time to care for your patients. Most don’t, but I do.

Nurse Charting In Duplicates – Confusing

I have been fortunate enough to work in a healthcare facility that had implemented EMR long before I graced it with my presence. However, there are still components of it that remain on paper, many of these duplications of items that are in the electronic chart, that cause me great frustration.

For example, we chart our vital signs electronically but also are forced (I say forced because believe you me, I have nearly begged to eliminate this frivolous duplication) to document on a paper graphic. The increase in probability for transcription errors alone has to be astronomical. It is also just a senseless waste of time and energy.

Nurse Charting Vital Signs Twice

This backward thinking and duplication just aid in the frustrations felt by nurses who are expected to embrace electronic charting. No one wants to do work twice, and nurse charting is no different. If healthcare providers expect for nurses to be on board with EMR (because it’s not going away, especially with the implementation of  Meaningful Use and the American Recovery and Reinvestment Act of 2009) then they need to expect physicians to be on board as well.

We are stuck charting these vital signs twice because there are a few MDs who just refuse to log into the computer to get the information. These are also the same physicians who bark at me to print discharge med recs, and lab values (both readily available in the EMR). I have never once been requested to print these items for a physician. It is always “I need the med recs for ‘so and so'” or “Where are the Labs for 235?!?!!?”. Never a please or a thank you or even a “Could you?”. It’s always “I need…”, “Where are…”, “Print me…”.

EMR and CPOE – Computerized Physician Order Entry)

I will be so thrilled when we transition to CPOE (Computerized Physician Order Entry) and the entire process will be on the computer. Perhaps then we can finally get away from the redundancy of much of our current charting and have more time to care for our patients.

Eliminating Duplications With EMR Charting Will Help Nurses

I recently got an email that said “Appear to have time to with your patients. Do not appear ‘rushed’.” I had to laugh at this. The basis of my practice in nursing is my integrity and honesty. You want me not to appear rushed? Then don’t make me be rushed. Eliminate duplications in nurse charting that are costing me valuable time that I could use to “Appear to have time”. I could appear it because I might have it!

But that, of course, is assuming we have appropriate staffing, which can be hit or miss. Safe Staffing: a worthy topic for another day… or days.

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3 thoughts on “EMR Charting: The Frustration of Duplication for Nurses”

  1. Great article. The redundancy is killer!! We did a partial EMR implementation at first. Then, we ended up using the redundancy to push through the rest of the EMR implementation. So, while I hate redundancy as much as the next person, it was interesting how we could use redundancy in order to drive the adoption of EMR technology.

    It seems the real issue you pose is who is required to do the redundant work. I suggest you have the person who needs to be most bought in to the EMR to do the redundant work.

  2. Time wasters: correcting all the mistakes the CPOE physician made–duplicate orders, contradicting orders, just plain wrong orders.
    When asked when labs results aren’t back, it is fun to say “You didn’t order any.”

    1. that will certainly be interesting.
      I spoke with a surgeon friend of mine about his opinions on CPOE and he said it is never executed properly. Too many warnings, popups and distractions that make physicians just click through because of frustration.
      In order to get people on board, the technology has to be made practical and easy to use. I hope that we can get there soon enough. This could aid so much in efficiency.

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