April 23, 2012

We must keep student access to handhelds in clinical

I just got back from a great trip to speak with folks from the Florida League for Nursing. During our conversations about the use of handheld computers many nursing faculty in attendance relayed stories of being denied use of handheld computers in the clinical settings. The reasons given for such a ban by a hospital are always a little fuzzy but I believe they are based on a few fears. As we know fear usually comes from lack of knowledge. Each of these fears can be easily answered.

Here are some of the fears and how nursing faculty need to respond:
1. A smartphone/handheld computer could be used for a HIPAA violation.
Response: There have always been ways to violate privacy of patients. All nurses and students are expected to act ethically, and there should be consequences if they don't. We just need to make the privacy rules clear, and the consequences for violations clear and consistent.

2. Those devices will cause interference with equipment that will endanger patients.
Response: Hospitals are full of radio interferences from the telemetry devices themselves, security radios, cordless telephones, light dimmers, fax machines, floor buffer motors, elevators, nearby cell towers, and of course visitors' cellular telephones. There is little evidence of interference unless the transmitting device is right next to the receiving device. Some ultrasounds and telemetry devices can be affected but just stepping back a few feet will stop the effect.

3. Patient satisfaction scores will be hurt because patients will think the nurses/nursing students are playing on their phones.
Response: I would first want data to see if there is even merit to this concern. I have had students using handhelds in the clinical setting for over 12 years and found patients like to see nurses looking up information that helps their care. Nurses need to explain and show what they are doing on the handheld, and the hospital needs to engage in some education through signs or orientation brochures explaining this is how nurses and physicians practice now.

We nursing faculty must be assertive in speaking with the hospital administration about the importance of this access. In the 21st Century it is impossible, and not even desirable, for nurses to know all the facts about the drugs, surgeries, procedures, and test results of their patients. There are more facts available every day but our brains stay the same size.

Nurses are users not just recipients of knowledge. Handheld devices help nurses use the facts to make clinical decisions.

And as a final argument, it was pointed out that the administration says nothing about physician use but feels it is OK to single out nurses for these restrictions. If I was at such an institution I would really press the administration for their reasons for such a double standard.

Nursing faculty cannot just let this happen without a fight. We need to be assertive and press our points. It is not only helps nursing education but nursing practice as well.