The widespread adoption of electronic health record (EHR) technology over the last half-decade has affected more than the practicing nurses and other healthcare providers who use EHRs in daily practice. The national initiative to move from paper to pixels has tasked nurse educators with a duty that is both very real yet somewhat hazy.
Nursing educators Mary S. Burke, PhD, RN, CNE, and D. Michele Ellis, PhD, RN, illuminate the challenge in a recent 2016 article in Nurse Educator:
“[Government] incentives are encouraging health care facilities to implement EHRs at a rapid rate, but each facility is free to choose the system that meets their needs. Consequently, nurse educators may now be required to learn to use multiple EHR systems when teaching students in clinical settings. In addition, there are frequent updates and changes to learn after the initial training.”
What’s the consequence for those saddled with teaching this moving target? Added stress — technological stress, or technostress, if we’re being specific — experienced by nurse educators trying to keep up with the fast-paced reality of facility-based EHR systems.
In an attempt to gauge the type of technostress experienced by nurse educators, Dr. Burke and Dr. Ellis conducted an online survey of 64 nurse educators teaching in clinical settings.
They found that, overall, nurse educators do experience mild to moderate technical stress linked with EHRs and clinical courses. Out of a possible score of 4, the overall technostress level reported by nurse educators was 2.86.
What specifically causes the technostress? Lack of student access to EHR training materials was the biggest stressor, according to the study. That technostressor was followed (in order of Nurse Educator Technostress Scale scores) by:
- the need to learn new EHRs,
- availability of EHR tech support,
- students’ knowledge of EHR, and
- access to EHR during clinical experiences.
In addition to reporting on the prevalence of technostress, the researchers offer some potential fixes on how to minimize the added EHR stress in nurse educators’ lives. For starters, nurse educator-IT staff partnerships would go far, they point out.
“The 5 items on the [Nurse Educator Technostress Scale] with the highest means all relate directly to the need for nurse educators to develop strong relationships with health information system personnel at health care agencies to receive training and support with the EHRs used in their clinical settings,” Dr. Burke and Dr. Ellis write.
Enhanced partnerships could be a win-win for both sides, they reason. Nurse educators trained and supported by a facility’s IT staff would, in turn, produce a crop of new grads/potential employees already highly familiar with the organization’s EHR. Were the facility to hire those nurses, it could save money and time normally dedicated to training new employees on the EHR system.
Other potential solutions include placing students in a single health system to prevent the need for nurse educators to learn various EHR systems. Along the same lines, assigning students to a specific clinical site for an entire semester could also cut the need to teach different EHR systems during that time.
Finally, the authors propose a clinical scholar model “whereby clinical instructors are employees of the hospital with consistent assignment to a clinical course and unit. Those instructors would be proficient with the EHR,” the educators write, “and this arrangement would provide improved access to resources within the clinical agency.”
In this day and age, few of us need researchers to tell us that technology, despite its many benefits, can add stress to our lives. This study, though, is eye opening because it steers our attention away from the main users of EHR systems to the nurse educators on the sidelines who are “technostressed out” because they are expected to teach a varied yet concrete competency.
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