National Nurses United

W ith the explosive growth of elec- tronic recordkeeping and other medical information programs in hospitals, CNA is pushing this year in con- tract negotiations to include unprecedent- ed language that protects RNs and their patients from technology that restricts their professional judgment or seeks to replace them entirely. Information technology programs have become the latest trend in health- care restructuring, with annual spending on IT spending mushrooming from $7.5 billion in 1993 to over $25 billion in 2004. Big hospital systems in California are investing heavily in the IT wave. For exam- ple, Kaiser is devoting $3.2 billion and Sutter $1.2 billion over the next decade on IT programs. With the Bush Administration and many in the healthcare industry promoting IT programs as the solution to medical errors and the answer to improving quality in healthcare delivery, CNA has many con- cerns about potential dangers in techno- logical restructuring and the implications for nursing practice and patient advocacy. Ultimately, says CNA, new technology needs to be skill enhancing, not skill dis- placing, and any new technology intro- duced into the healthcare setting must be optional, not forced on caregivers, and pro- vide guarantees for interpretation and clini- cal judgment. CNA's contract proposal would, among other things, create a "technology assess- ment group" of RNs which would evaluate, give input, and create operational stan- dards for new technology by having the power to request information or demon- strations from the hospital and vendors. The recommendations RNs now give to hospitals in response to new technology are often ignored or they never get to dis- cuss the proposal at all, say RNs. "We always say we want to talk about what they're planning to do before they do it," said Barbara Williams, a psych RN at CHW's Dominican Hospital in Santa Cruz and CNA board member. "They go, Oh okay, and nothing happens. You'll make com- plaints, but we can't do anything about it." Many RNs are very concerned about what direction technology is taking patient care. "The hospitals and healthcare com- panies want programs that substitute knowledge and training with cookie-cutter approaches," said Williams. "But anyone who actually works with patients knows that doesn't work, because every individual is different and needs an individual assess- ment to figure out what works best." The goal is to have technology com- plement the care that nurses give, not replace, override, or dehumanize what nurses do. Genel Morgan, an ICU RN at Sutter's Mills-Peninsula Medical Center in Burlingame, is worried that nurses are pay- ing more attention to the computers than to the patients. "We have problems all the time, where the printers don't work or the machines don't talk to each other," she said. "It takes them forever to get fixed and, meanwhile, we're trying to take care of patients!" With computerized bedside charting, Williams also noted that patients have complained that they are disturbed that the RNs are staring at the computer screen instead of looking them in the face when asking questions. "Some of the eld- erly patients have hearing problems," she said. "And it's very alienating." Negotiations Seek New Language on Technology Cover | Story ■ ■ ■

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