Saturday, January 16, 2010

Learning in a Technology-Advanced Society

As a US migrant nurse, there are a lot of things that I had to adjust to. Although I already practiced in a hospital which boasts of being hi-tech and fully equipped with state of the arts facilities, it was still different when I came here.


All nurses in the floors and ICUs have computer monitors which they just push and pull around as they do their rounds. Charting is done through this monitor. When they give medications, they scan patient's wristbands which has a barcode on it and then scans the medicine to ascertain that the right drug is given to the right patient at the right dose, time and route. I had to attend a one-day course, learning a computer software which one of the hospitals used.


As for the medicines that we give to patients, I had to get my fingerprint into the computer system called Pyxis so I can have access to the drugs. The process goes this way: the doctor writes down the order, the nurse scans the order sheet to the pharmacy, the pharmacist checks on the order to make sure that the patient is getting the right dose and has no medicine which interacts with the new drug as well as no history of allergy for that particular ordered drug. The drug is then encoded into the patient's computerized record so that it is made accessible in the system. There are drug stations for each unit which they call Pyxis. I automatically charges these medicines to the patient as soon as I get the medicines out of the Pyxis using a username and my fingerprint as "password".


There is also one hospital which is more advanced than the rest. The medical supplies are located in a central supply room in each floor. To gain access to the room, you need an ID badge which you swipe into this machine by the door. Inside the room, there is a scanner which you use to scan into the buttons which represents patient's rooms so it gets charged to the right patient, then you scan the buttons on the boxes containing the supplies which you will be using for the patient.


Sending blood specimen to the lab is just as fast. We just put the test tubes in a canister which we dock inside a pod. We press the key (e.g. LAB) where we want the specimen sent. This goes through the wall and we call it "tubing the specimen down to the lab". One hospital would also tube blood packs for transfusion using this system as well. Request for blood therefore takes only a couple of minutes. Laboratory results are also out in the computer system within an hour.


Another thing that I noticed also is that all nurses have their own hospital phones. When I needed to endorse back the patient to the unit, I simply call the unit secretary and she connects me to the phone of the nurse who is in charge of the patient. Sometimes, the nurse would leave her phone number so I could call her directly.


There are a lot of other gadgets which I had to orient myself with, because I never got to handle these in my own country. A basic one would be figuring out how to operate a bed with all its many features and functions. It had to be demonstrated to us. And all these technological advancements are supposed to provide better quality of care to the patients.


But one thing which I am really thankful about, amidst all these technological confusions and challenges is that people here make you feel that it is alright to be a little ignorant, it is alright to ask, it is alright to admit that you do not know. And that makes a lot of difference in my adjustment as a technologically-challenged nurse. Without judgment, I was accepted and understood.


And rarely do I see patients look down on a new nurse. They were encouraging. I even had one patient apologizing to me because I had difficulty sticking a needle on her. She said she was sorry for making my job difficult, as though it was her fault! And when I finished doing the dialysis, she was very generous with her words of appreciation. Then I realize that when it comes to showing appreciation, I was stingy. I am more vocal about criticism rather than appreciation. And so I came to learn to verbalize words of gratitude as well. I learned to be more generous with kind words. I then realized that I have improved my quality of care to my patients not so much from the technology that was available to me, but more from the kindness and appreciation that I learned from them.

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