Impact Insights

I AM an Emergency Nurse, My Story

Terri Fitzgerald

Emergency nursing has always been my passion and my identity for years. My entire career has been in the Emergency Department (ED) working as an ED Staff Nurse, ED Director, and Trauma Nurse, never tiring of my hectic and immensely rewarding career choice.

Several years ago I was offered an opportunity to work with the IT team to customize and implement an Electronic Medical Record (EMR), Epic, for our three Emergency Departments. Thinking this was a temporary consulting role, I agreed to transfer to the IT department to help design this new EMR. I was just settling into my new “cube world” when I was sent off to Madison, WI to obtain both Epic ASAP (ED) and Ambulatory certifications. I thought it odd that they were sending me, an advisor, but thought the education would serve me well, so happily went along.

Then I found out that Epic certifications involve completing major projects and timed tests. While completing these requirements I consistently moaned “I am an emergency nurse. I should not be taking timed tests!” Despite the whining, I successfully completed my certifications and actually found that I enjoyed designing and building the new EMR. I was now an IT Analyst and former ED nurse.

I moved into the consulting world and began working with nurses and physicians throughout multiple organizations to assist with design and implementation of their EMRs. Understanding the workflow, patient needs, documentation requirements, and how ED staff must multi-task and change priorities in an instant was crucial in helping them create a streamlined documentation tool. It takes an ED nurse to understand the build needs and complexities. Could it be that I was still an ED nurse? That confirmation came in the middle of a trauma resuscitation.

Trauma teams generally resist electronic documentation because paper trauma documentation is thought to be much quicker and easier during the intensity of a trauma resuscitation. However, documentation on paper does not provide medication and duplication alerts that improve patient safety. Additionally, the OR and ICU nurses must retrospectively enter paper documentation into the EMR, increasing the potential for errors. Taking this into consideration, our IT and traumas teams worked together to design and build Epic’s Trauma Narrator with the goal of improving patient safety with real time documentation.

Shortly after the Trauma Narrator was moved to production, our IT team was notified that a trauma patient was en route. We had a lot invested and I think we were more nervous than the trauma nurse awaiting the patient’s arrival. Our IT team logged on to the EMR to observe the nurse and provide guidance if needed. As it turned out, the nurse did not need our assistance and transitioned to electronic documentation quite smoothly. As for me, the former ED nurse, I was back! Although I was 10 miles away in a cubicle, just watching the documentation, I felt the excitement of being back in the trauma room and took pride that I had a part in improving safety for this patient. It was then that I realized that I was not a former ED nurse. I am an ED nurse specializing in electronic documentation.

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