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Technology and Professional RN Judgment Over the past decade, American health care corporations have invested upwards of $700 billion on information technology (IT) systems. Computer experts, hospital management, and investors cheer the advance of new hospital technologies, which is a multibillion-dollar market. They claim these systems save time and money, improve patient care, and combat the liability of medical error by keeping more accu- rate and comprehensive records. RNs who actually use these systems day in and day out have found that the kind of care we can provide with this new technology is limited. The programs and machines are often counterintui- tive, cumbersome to use, and sometimes simply malfunction. In worst-case scenarios, entire systems have crashed, putting nurses' ability to provide safe, timely patient care at risk. Nurses find that the introduction of these technologies is fundamentally undermining the nature of nursing. We can't focus our full attention on observing and assessing our patient when our eyes are constantly on a computer screen and our hands are clicking a computer mouse. The hospital industry is also deploying technol- ogy to slash the costs associated with hands-on care by promoting telehealth as a "convenient" alternative. In 2020 the Covid pandemic pro- vided the hospital industry with a perfect excuse for greatly expanding telehealth. CNA/NNU will monitor this situation closely to challenge inappropriate uses of telehealth and to assure that an overreliance on telehealth is not made permanent. Objections to any form of technology are made based upon the expert judgment of the direct- care RN. Be sure to fill out an ADO form. Reasons to Fill Out an ADO » Lack of current demonstrated and validated competency . » Threat to health and safety of your patient. » Use of rigid predefined model/standard of electronic documentation. CNA/NNU Contracts In anticipation of these kinds of troubles at hospitals in California and across the country, CNA/NNU has for several years more aggres- sively pushed for RNs to play a greater role in reviewing and approving new technologies before they are introduced. Contract Language » Technology must be consistent with the provision of safe, therapeutic, and effective patient care. » Deployment of technology shall not limit the RN's scope of practice related to the nursing process including full exercise of clinical judgment in assessment, evaluation, planning, and implementation of care — nor from acting as patient advocate. » Technology is intended to enhance and complement, not degrade, nursing skills. » The manner in which technology is used shall support patient confidentiality. » Technology is intended to provide informa- tion and options for clinical decision making. Clinicians will maintain account- ability for actual clinical decision making, including incorporating individualized patient needs, complications, and comorbid- ities, as appropriate. Patient Advocacy— Our Guiding Principle Collective Advocacy 32 RNs in Motion