Skip Navigation LinksHome > May/June 2014 - Volume 12 - Issue 3 > Managing your digital work life
Nursing Made Incredibly Easy!:
doi: 10.1097/01.NME.0000445318.95823.7b
Department: On the Horizon

Managing your digital work life

Brothers, Kandie MSN, RN, CNL; Davis, Charlotte BSN, RN, CCRN; Kelton, Diane BSN, RN; Shuss, Stacy RN

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Author Information

Kandie Brothers is a Nursing Clinical Faculty Member, Prevention and Management of Disruptive Behavior Coordinator, and Introduction to Critical Care Program Coordinator at the VA Hospital in Nashville, Tenn. Charlotte Davis is a CCU/CVICU Clinical Nurse at Heritage Medical Center in Shelbyville, Tenn., and a Clinical Nurse/Charge Nurse/CCRN Review Program Coordinator at Alvin C. York VA Medical Center in Murfreesboro, Tenn. She is also a Nursing made Incredibly Easy! Editorial Advisory Board Member. Diane Kelton is a Nurse Manager at Alvin C. York VA Medical Center in Murfreesboro, Tenn. Stacy Shuss is a CCU Clinical Nurse at Heritage Medical Center in Shelbyville, Tenn.

The authors have disclosed that they have no financial relationships related to this article.

As technology continues to advance, the healthcare community has benefitted by utilizing innovative electronic devices to improve our efficiency, communication, diagnostic capabilities, patient and staff education, and clinical outcomes. Many hospitals are using devices such as smartphones, tablets, and laptops to assist healthcare personnel while performing their duties.

However, there are times when using these devices can send the wrong message to our peers and patients. Inappropriate electronic device usage can convey to others your lack of attention and even disrespect. In this article, we give you tips on when to stow your devices and when to use them to improve patient care.

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Red light

You should consider turning off your electronic devices or switching them to silent mode during professional presentations, formal organizational meetings, and patient care.

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Professional presentations

When your peers have spent time and effort to research data, compose a presentation, and arrange for a meeting location, you should convey your appreciation by giving your team members your full attention. When cell phones or pagers sound during a presentation, it can distract the speaker and audience from potentially in-depth concepts that require everyone's full concentration to understand. Unless your personal smart phone, laptop, tablet, or e-reader is part of an interactive presentation, these devices should be turned to an off position.

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Formal organizational meetings

When you're attending a formal organizational meeting, your attention should be solely focused on the topics that are being discussed—topics that can impact your clinical work area or your job role. It's vital that we engage interactively during organizational meetings while discussing, planning, and evaluating new policies, systems, treatments, and protocols that impact clinical outcomes. Nurses possess a valuable and unique insight that can dramatically improve the productivity and efficiency of the organization, as well as the clinical outcomes of the patient population.

If you're present at a professional meeting and are unable to turn your pager into the off or vibrate position, you should inform the group at the beginning of the meeting that you may receive a page and explain why you can't silence it. For example, “I'm on the rapid response team and can't silence or turn my pager off. I'm asking for your understanding and tolerance in the event I'm paged.”

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Patient care

When we utilize electronic devices while in the presence of a patient to answer a personal phone call, check a personal text message, or actively play a game, it conveys a lack of attention to the patient's healthcare needs. Although nurses are notorious for being adept at multitasking, patients and their families can easily spot a distracted nurse.

Utilizing electronic devices for personal use while at work can distract you, increasing the chance of errors. Peers may view you as being unavailable when they're in need of assistance. And doing so also sets a poor example for coworkers and novice nurses.

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Green light

Although there are inappropriate times to utilize our electronic devices, there are also situations in which these devices can make our jobs more efficient. Electronic devices can be used to improve our patients' healthcare experience and the safety of the care delivery system. Consider the following examples.

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Smart phones

Smart phones can help keep us connected to other healthcare team members, allowing us to move freely throughout our work area to provide patient care while still being accessible. They can also be used to reach us in times of organizational, local, or national emergencies.

Recent research shows that smart phone apps, such as drug compatibility guides, clinical reference guides, and pathophysiology references, are being routinely utilized within hospitals and have improved nurses' productivity and efficiency. If approved for use by your facility, there are apps that can be utilized in the direct assessment, diagnosis, and treatment of patients. The FDA predicts that by 2018, half of the more than 3.4 billion smart phone and tablet users will have downloaded at least one medical or health app. There are currently 100 smart phone medical applications that have been approved by the FDA.

Common nursing uses for smart phones include:

* reading the latest medical news or newest edition of your favorite nursing journal

* listening to a new podcast on a healthcare topic

* accessing saved documents from a virtual library, including multipage PDF documents such as clinical guidelines

* sending or receiving text messages to or from a coworker to communicate your itinerary or need of assistance with a patient or task

* accessing patient schedules or test results on secure apps that have been approved by your facility

* setting the alarm to remind you to follow up with a patient need or complete a time-sensitive task or assessment

* accessing patient education materials that have been approved by your facility to utilize during patient care

* using calculators to formulate correct drug dosages or infusion rates

* instructing patients to archive personal healthcare data that may be needed for follow-up appointments, such as daily BP or blood glucose results

* calling for assistance from security or police if there's potential or imminent danger to yourself or your patients.

Don't store user IDs, passwords, or identifying patient information in any smart phone. If the phone is lost, it can pose a security risk because patients' sensitive healthcare information may be accessed. Security features that require the user to enter a personal security code should be activated on all professional and personal smart phones.

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Laptops

Laptops are commonly utilized in healthcare facilities; for home healthcare; by emergency medical services; and in healthcare services, such as telemedicine and well-check house calls made by physicians or paramedics to patients who've had numerous ED visits within a 4-week period. Laptops can also be beneficial when hospitals are coordinating emergent services during transfer.

Tele-ICU healthcare personnel utilize laptops equipped with videoconferencing capabilities. Due to a significant shortage of physicians trained as ICU specialists, hospitals located in rural areas often don't have personnel adequately trained to deliver timely and appropriate critical care interventions to severely ill patients. Tele-ICU enables ICU physicians and critical care nurses to monitor patients from anywhere in the world.

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Tablets
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Tablets can be effectively utilized to assist the nurse in providing comprehensive patient education. 3-D anatomical teaching models can be uploaded to the tablet to allow the patient to visualize an illness, injury, or disease. Tablets can also have special apps uploaded to them that link to diagnostic data. Many healthcare facilities ensure that their clinical staff members have access to tablets to convey diagnostic information, such as images of a broken bone or space-occupying lesions, to patients and families. This allows the patient and family to better understand the diagnosis and treatment plan.

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E-readers

Electronic book devices can be used to download healthcare resource books for reference by nursing staff and patients. They can also be used to download the latest professional journals for all healthcare team members to stay up to date on the newest research, procedures, medications, or dilemmas facing healthcare personnel. In addition, patients who have extended stays in a healthcare facility may enjoy the distraction of reading a novel on an e-reader.

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Digital audio players

Personal digital audio devices can be utilized by patients to listen to music, which may reduce pain, anxiety, stress, depression, insomnia, and nausea. They can also be utilized to provide educational podcasts to a patient or family on a diagnosis, procedure, or medication.

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Gaming devices

Gaming devices can be used by patients or family members to decrease stress levels. Interactive gaming devices that require physical movements are commonly being utilized in long-term-care facilities as a recreational activity. These games can be beneficial in engaging patients in social activities and maintaining range of motion. Recent research has shown that utilizing virtual gaming devices for patients who've experienced a stroke greatly improves recovery of their motor skills. And handheld gaming devices are ideal for children in pediatric hospitals because they offer a much needed distraction from the child's underlying health condition as he or she returns to an optimal level of health.

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Digital do's and don'ts

Although electronic devices have certainly improved the healthcare services we provide, we must ensure that we continue to utilize these devices with the proper etiquette to maintain our professional reputation as healthcare leaders.

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cheat sheet

Device do's and don'ts

Do:

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* utilize electronic devices that are approved by your facility to improve your patient education sessions

* ensure that electronic devices are updated with facility-approved software to protect all patient information

* use electronic devices to improve your accessibility to your team members and patients per your facility's policies.

Don't

* post private health information about patients on social media sites

* use electronic devices to access social media sites while at work unless you're on an assigned break and it's approved by your facility

* utilize personal electronic devices to maintain social connections with family and friends while at work unless you're on an assigned break and it's approved by your facility.

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Learn more about it

Doran DM, Haynes RB, Kushniruk A, et al.. Supporting evidence-based practice for nurses through information technologies. Worldviews Evid Based Nurs. 2010;7(1):4–15.

Doran DM, Reid-Haughian C, Chilcote A, Bai YQ. A formative evaluation of nurses' use of electronic devices in a home care setting. Can J Nurs Res. 2013;45(1):54–73.


Medscape.com. 15 more smart phone apps to improve your practice. http://www.medscape.com/features/slideshow/apps2.

Saposnik G, Teasell R, Mamdani M, et al. Effectiveness of virtual reality using Wii gaming technology in stroke rehabilitation: a pilot randomized clinical trial and proof of principle. Stroke. 2010;41(7):1477–1484.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. All world rights reserved.

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