National Nurses United

I t all started with the breakfast orders. That's what Lisa Watson, RN, remembers as the first sign some- thing was wrong at Ascension via Christi St. Francis Hospital in Wichita, Kan., in May 2024. Nurses at St. Francis weren't unaccustomed to downtime for their computer systems, as updates are a fact of life in any computerized workplace. But, in the coming hours, Watson says things went "downhill" as more and more of the technology around them crashed. Across town at Ascension Via Christi St. Joseph Hospital, Carol Samsel, RN, was at work on the critical care unit as systems started to go down. "Probably by midafternoon, nothing was able to be done on the computer anymore," remembers Samsel, who's been a nurse for nearly 40 years. "We didn't have an answer from the hospital, but, by the end of the day, we were doing everything on paper." Eventually, nurses discovered that Ascension was dealing with a cyberattack that was shutting down the computer systems at hospi- tals nationwide, including four recently unionized Ascension facilities represented by National Nurses Organizing Committee: St. Francis and St. Joseph hospitals in Wichita, Ascension Seton Medi- cal Center Austin (ASMCA) in Texas, and Ascension Saint Agnes Hospital in Baltimore, Md. Other National Nurses United affiliates also represent nurses at Ascension facilities, such as Michigan Nurses Association's unit at Ascension Borgess Hospital in Kalama- zoo, Mich. The hack took down computers nurses relied on for patient- care basics like ordering food, getting test results, fulfilling and administering prescriptions, paging staff for codes, and charting in electronic health records. All told, key systems were out for roughly a month as the cyberattack dragged on. That left just one key system left to do the work: The nurses. Nurses hack back By the end of her shift the first day of the hack, Samsel says nurses had coordinated a rapid-response crash course on paper charting. While some of the veteran nurses remembered hospital life before the move to computerized electronic health records, many newer nurses had never charted on paper before. "'Chart your assessment here. Here's your vitals. Write out all your orders. Cross out the rest of the page so nobody else goes back and writes anything,'" Samsel remembers telling the newer nurses. "The first few days, we had somebody there who had done paper charting. We had an experienced person there to tell people how to do it." These kinds of human double-checks were essential as com- puterized checks were offline. In Baltimore, nurses reported that disruptions started as they tried to clock-in, with timeclocks down. Internal communications being down meant things slowed down, too. For example, rather than getting orders for things like vascular access through their computers or hospital-provided computerized pagers, nurses had to rely on their office phone's voicemail, rushing back from setting up IVs in one unit to find out if their next patient was waiting already for them. Unionized nurses in Austin were also trying to adapt. Basic patient care tasks were hugely impacted, remembers Kristine O C T O B E R | N O V E M B E R | D E C E M B E R 2 0 2 4 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 19 Hard Reboot When a cyberattack took down their computer systems, Ascension nurses relied on their most valuable infrastructure: themselves. By Lucy Diavolo

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