By Ericka Waidley, MSN, RN
October 7, 1999

Q: I graduated with a BSN in 1996 and have been working in a busy med/surg unit. I know for a fact that bedside nursing is not my calling, and I am interested in healthcare information systems and nursing informatics. I have had great difficulty moving into this field. Can you give me some pointers?

A: I think you will find that most nurses in the field of information systems have several years of experience in various clinical specialties. The reason for this is that information systems covers a wide spectrum, including patient care, general and intensive specialties, inpatient and outpatient departments, finance, and business and office functions.

This field also relies upon knowledge from several different theoretical bases. These might include systems theory, organizational development and design, sociotechnical theory, learning theory, process design and function, and all of the computer technology and accompanying skills.

However, information systems is an excellent career choice for nurses because our clinical expertise and knowledge are sought after as more and more technology-based systems are developed. Nurses have expertise in patient care and care delivery systems, and any technology used in a healthcare environment requires knowledge in these areas.

There are several things you can do to be better prepared for a career in nursing information systems. First, you should transfer into an intensive care unit, where you will be exposed to more of the high-tech equipment and functions. As you gain more experience clinically, you should also let your supervisor know of your interest in information systems. You can volunteer for committees or task forces concerned with equipment or unit systems (budget, materials management, computer training, etc.) You may also have opportunities to network with computer or systems vendors and learn more about their side of the business.

At the same time, you may also want to take some computer classes. Most community colleges and regional occupational programs have classes in computers and computer technology. There are also many books available to help you become more computer literate.

Finally, you should make sure that the information systems manager in your hospital knows that you are interested in this field and are taking the initiative to develop new skills. It may take hard work and a commitment on your part, but you will be ready to make the move to information systems when an opportunity is available.

Q: I work in the emergency room. In the past we have been given a choice of whether to have our first name only, or our first and last names on our name badges. Now our supervisor is making it mandatory to have both names on our badges. We want to protect our privacy! Is there a law that states you must have your last name on your badge?

A: There is, in fact, a new law in California. AB 1439 went into effect on Jan. 1, 1999, and states that all healthcare practitioners must be identified with their name and practitioner license status (title) in at least 18-point type. The bill does clarify, however, that “if a healthcare practitioner or licensed clinical social worker is working in a psychiatric setting or in a setting that is not licensed by the state, the employing entity or agency shall have the discretion to make an exception … for individual safety or therapeutic concerns.”

Many hospitals and clinics print their name badges with the first name in large print and the last name in smaller print underneath. This technique still meets the requirements of AB 1439. Because there are so many similar first names, it is hard for patients and their families to distinguish among the staff taking care of them over a 24-hour period; therefore, a last name needs to be included.

While I understand the issue of privacy, I also understand the importance of our patients knowing who we are. We should be proud of our practice and confident in our ability to give good patient care. We also need to recognize that our patients are often elderly, with compromised eyesight, or they are in a crisis situation and feel an increased need to know what is happening. In such situations it is important for us, the care providers, to identify ourselves so our patients can remember who is taking care of them. Clear name badges will help.

As an employee, you are protected by your human resources policies and procedures and by your civil rights. If you feel that your privacy is being violated or are concerned about your welfare or safety, you should immediately notify your supervisor and your human resources department. It is the hospital’s responsibility to protect the rights of its employees as well as the rights of its patients and their families.