Nurses with a passion for data – that’s one of the key components of success for chief nurse informatics officers.

Those in this role in healthcare organizations understand the specific pressures and duties that nurses face, and how information technology can help improve their ability to deliver care to patients, and use the right IT tools to accomplish that goal.

Several board members of the American Nursing Informatics Association recently shared from their past experiences, aiming to help nursing students and new chief nurse informatics officers with the lessons they learned in their early years as CNIOs.

ANIA leaders say that aspiring CNIOs need to be willing to take chances and be a part of the solution to problems that are impacting nursing care.

Patricia Mulberger, RN-BC, MSN; Clinical Informatics Quality Supervisor, Kalispell Regional Healthcare, Kalispell, MT; ANIA West Region Director;

Don’t try to do it all on your own. Find a mentor. You don’t need to have one at your organization – I I didn’t – and even if you do have someone local, you still want to connect globally with others in your profession.

Networking is invaluable. When I moved from bedside nursing to informatics in 1995, I was unaware of this organization, but I did join my vendor’s user group list-serve. I shared everything I was doing and found that my peers across the country were extremely willing to share as well.  That sense of camaraderie helped me build self-esteem in my new profession. I worked in a rural setting and believed I didn’t know enough to be very valuable. Along the way, I found that my knowledge was much more global than that of someone who worked in a large organization with one specific application.  

Never underestimate what you know, and always be open to new ideas. The way to keep open to new ideas is to refuse to take things personally. Say you built it and it is great, and then you implement it and get all kinds of negative feedback. Don’t let that take the wind out of your sails. There’s always a better way, and staff will respect you if you jump back in and work with them to improve the process. It is always about improving the process, continually. There is no point where it is perfect. I had to learn to accept that. Given my penchant for perfectionism, that was probably the hardest lesson for me. This is where global networking became my savior. I found out through ANIA that my peers around the country (and world) were struggling with the same issues. I wasn’t alone. So don’t try to do it on your own.    

The innovation needed today requires explorers who are courageous enough to take a leap of faith and follow it to the end. It is not dependent on high-ranking executives, but on the person that has some knowledge of patient care and will place that knowledge beside current trends in technology. It is dependent on the person who doesn’t expect it to be perfect the first time, or even the tenth time. As a budding informaticist, you go in, try to incorporate healthcare workflow and technology to the best of your ability, and you try it out. What doesn’t work, you try again.       

Most importantly I urge informaticists to join our professional organization.  Don’t hesitate to ask questions. Many times, novices on the ANIA e-list will ask if someone would be willing to speak with them over the phone about an issue, and there is always a huge positive response. This is the same with your vendor’s user groups. I believe in constantly educating myself and sharing new learnings with others. And I am thankful that others do the same for me.   

Brenda Kulhanek, PhD, MSN, MS, RN-BC; Corporate Director of Clinical Practice at Adventist Health; ANIA Director of Education;

Like many of my colleagues, my transition to becoming an informatics nurse did not begin as a planned event. In the late 1990s, my home care organization was piloting a laptop-based patient care documentation system. I had recently purchased a home computer and quickly learned that I had a knack for technology. I volunteered to pilot the new system, which never did get off the ground. Since that time, I have had the opportunity to develop my informatics experience from multiple perspectives, including as a care provider, an IT employee, a nurse leader and as a vendor.

The specialty of nursing informatics focuses on the identification, definition, management and communication of data to support and develop information, knowledge and wisdom in nursing practice. A passion for data, the vision for what can be accomplished with data, and the knack for working with technology are all essential elements for a successful career in nursing informatics.

When teaching informatics in my adjunct faculty role, I occasionally see clinical nurses who have returned to school to obtain a degree in informatics to get away from the bedside. Most often, without the passion for data and the knack for working with technology, these students struggle with the program. On the other hand, I have seen nurses enrolled in a nurse practitioner or nursing leadership track who have discovered that they possess a passion for data. This discovery is often followed by a switch in graduate programs.

If you are considering a career in nursing informatics, it is essential that you have that passion for data and vision for what can be accomplished with data; a large amount of tolerance for change; and a sense of inquiry and innovation. These skills will enable you to continually improve the care that we provide our patients by supporting our caregivers with the best information and tools possible.

Nicole Mohiuddin MS BSN RN-BC CPHIMS FHIMSS; Director of Clinical Informatics, Kirby Medical Center, Monticello, IL; ANIA Central Region Director;

Looking back at more than 15 years in informatics, the biggest lesson I've learned is the essential need to maintain a big-picture, holistic perspective at all times and in all undertakings. Whether implementing a healthcare IT system, integrating a medical device or just optimizing clinical workflow, it can be far too easy to forget that there is a surrounding ecosystem and that the patient is at its center.

All of us in healthcare have to consider how what we do will affect the patient and how it will impact the workflows of clinicians and supporting disciplines, such as finance, medical records, admitting, risk management, biomedical engineering, quality improvement, pharmacy and others. The interdisciplinary nature of informatics presents both the opportunity and the mandate to champion such a systems approach. Sometimes, that perspective is welcome; sometimes it can be resented; but it is always important, if we are to deliver safe, efficient, effective, patient-centered healthcare.

Cheryl D. Parker, PhD, RN-BC, FHIMSS; Chief Nursing Informatics Officer, PatientSafe Solutions; ANIA Secretary;

A lot has changed in the past 18 years since I got into nursing informatics, but here are some things I learned. CNIOs should network. My volunteer work with various professional organizations has gained me so much. When you volunteer and do a good job, the network you gain can lead to many cool opportunities.  It's not always easy to carve out the time, but it has been worth it.

This is the kind of position where you need to take risks. I once took a job where the only job description I could get was "it's broken – fix it," but not one of the executives could explain what "it" was. I figured the worst that could happen was that I could fail miserably, but learned a great deal in the process.  I was there for five years and was very successful.

Conversely, it’s not the kind of position where you should be complacent. Look down the road and keep improving your skill set – four years ago, everyone was focused on implementation skills, and now the tide is shifting to data analysis and visualization.  Education can be formal, such as a new degree or certification, or informal, but even if you are the best at something, you can't stop learning.

Kathleen (Kathy) Hunter, PhD, RN-BC, CNE; Director, MSN Program, Chamberlain College of Nursing, Downers Grove, IL; ANIA Research Director;

Looking back on my career in nursing informatics, one of the first lessons I learned was that if you see a need, propose a solution that includes you. In 1979, I worked the night shift full-time in the critical care recovery unit at the Maryland Institute for Emergency Medical Services (MIEMS), the first shock-trauma unit in the United States. I worked night shift because I had returned to nursing school to earn my master’s degree.

During this time, an intensive-care information system, which ran on a DEC PDP-11, was implemented in the CCRU with connections to the clinical labs. Each patient cubicle had a state-of-the-art dumb terminal known as a VT-52.  I would spend quiet times during my shifts exploring the software, including the patient assessments and data-graphing functions.

The ICIS enabled nurses to view nearly any combination of data elements in tables or various graphic presentations. Because much of our nursing data management involved real-time trend analysis of patients’ data, I could see real benefits rising from manual entry of nursing and laboratory data combined with automatically collected hemodynamic data. At that time, no nurses were directly involved in the design, development, or implementation of the ICIS’ data sets or functions.

I went to the MIEMS director and the ICIS director, advising them that nursing input was needed. When they asked who would provide this input, I said, “I will.” These words have led me on an adventure-filled journey in nursing informatics, with vendor, practitioner, consultant and educator roles.  Along the way, I’ve continued to advise other nurses with an interest in nursing informatics to educate the leaders in their organizations about the need for nursing involvement and volunteer to fill the need.

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