Industry Voices—The best way to honor nurses and midwives? Fight burnout

The pandemic underscores the vital contributions that nurses make worldwide each day and their firm commitment to delivering patient care—even when it places their own health and safety at risk. (Getty/monkeybusinessimages)

When the World Health Organization designated 2020 as the International Year of the Nurse and the Midwife, no one expected that 2020 would also be the year we would find ourselves in the midst of the worst public health crisis in more than 100 years.

The pandemic underscores the vital contributions that nurses make worldwide each day and their firm commitment to delivering patient care—even when it places their own health and safety at risk.

While the current situation has taken a physical and mental toll on all of us, there is at least one silver lining: Nurses are receiving well-deserved recognition for all they do.

Images of front-line nurses are grabbing headlines as the media spotlights their tireless work serving their communities. News stories feature ICU nurses helping isolated patients video chat with loved ones because hospitals have banned visitors. We are reminded that nurses are putting their patients first, even as they worry about getting sick or spreading the virus to their own families.

COVID-19 is fueling tremendous stress for nurses, who were already experiencing escalating stress levels and burnout even before the pandemic—especially due to stress created by poorly designed electronic health records (EHRs). If we want to truly honor nurses, we must find ways to reduce workplace burnout and minimize stresses, including those triggered by administrative burdens, demands to see more patients in less time and requirements to use EHRs that disrupt workflows instead of enhancing them.

Fixing EHR inefficiencies

Among healthcare workers in the U.S., more than 3.8 million—about 40%—are nurses. Despite their large numbers, nurses are often an afterthought in conversations about the growing problem of stress and burnout in healthcare.

Like physicians, nurses are heavy users of EHRs, which are rarely aligned with nursing workflows. Nurses often complain that EHRs negatively impact their productivity and interfere with the nurse-patient relationship. The burden of EHRs, along with heavy administrative workloads, are driving professional burnout and ultimately impacting performance, recruitment and retention, and the patient experience.

One way to ensure more efficient workflows is to include nurse leaders and front-line staff in EHR project planning, clinical governance and system design. For example, nurses can share their expertise on workflow requirements, which vary significantly depending on role, department and specialty. As subject matter experts, nurses can guide implementation teams to create customized and efficient workflows that users will embrace.

Nurses can also guide changes to improve the delivery of direct patient care. A common source of frustration is the inability to quickly access information for clinical decision-making. Instead of wasting time searching through disconnected data silos to find critical details at the point of care, nurses need efficient workflows that deliver clean, well-organized information about the patient in front of them. Access to the right data at the right time enhances nurse productivity, allowing more time for patient interaction and proactive care planning.

As key stakeholders in the EHR design and implementation process, nurses can also provide insight into their interdisciplinary communication requirements. All team members, regardless of role, need quick access to the most up-to-date details on a patient’s status—but this objective can be a challenge when users in different care settings use different clinical systems. Nurses can clarify why seamless communication is essential for care collaboration and advocate for solutions that provide bidirectional interoperability between disparate systems.

Improving the nurse experience with technology

COVID-19 has highlighted nurses’ tremendous contributions to healthcare as well as the immense stress that comes with the job. Before the pandemic, we faced a predicted shortfall of 1.1 million registered nurses by 2022 as nurses retire or move to other roles from bedside care. Healthcare leaders now worry that the strain of COVID-19 could fuel greater nurse burnout and more nurses opting to leave the profession sooner.

To help alleviate nurse frustration and burnout and improve nursing efficiencies and productivity, organizations need to embrace technology that supports the nurse experience and minimizes administrative burdens.

Healthcare leaders, with input from nurses, must consider new and emerging technologies such as artificial intelligence and clinical decision support solutions that enhance existing EHRs by complementing nurse workflows, freeing nurses to use their time and skills more effectively.

Nurse leaders should prioritize high-impact technologies that address key challenges, such as:  

Clinical decision support tools for care planning and documentation. Using AI-based clinical decision support tools, organizations can automate the creation and updating of care plans and documentation. Rather than spending time creating plans manually, nurses have access to customized care plans that are evidence-based, multidisciplinary and patient-focused. Nurses can simply review the final product and edit by exception.

Point-of-care technologies that enhance decision-making. Patient care is optimized when nurses have point-of-care access to technologies that provide relevant practice guidelines in real time. Clinical AI, analytics, decision support tools and similar technologies facilitate informed, faster decision-making, compliant documentation and safe guidelines for high-quality, evidence-based care.

Nurse frustration is minimized because users can quickly find specific information while spending less time entering repetitive, unstructured text. Such solutions can also produce precisely coded clinical documentation automatically, which facilitates advanced reporting, operational planning, research and compliance review.

Tools that guide best practices. Technology cannot replace nurses, but it can augment nurse capacity and the skills of less experienced care team members. Again, the pandemic has shone a bright light on how stretched our healthcare system is for nursing resources. For example, decision support tools that use evidence-based practices can guide a nurse to decide “what to do next” when a patient’s status is deteriorating or is admitted with a rare diagnosis. In addition to enhancing patient care, in-workflow guidance can increase staff confidence and speed and reduce stress levels.

As the U.S. and the world wade through the pandemic and look toward the future, it’s more important than ever for healthcare leaders to take measures to mitigate workplace stress and to seek ways to minimize the burnout crisis. In the International Year of the Nurse and Midwife, let us honor these healthcare heroes by embracing innovative technologies that increase efficiencies, support productivity and improve the everyday work lives of nurses.  

Toni Laracuente, R.N., is the chief nursing officer of Medicomp Systems, a provider of clinician-driven point-of care solutions that fix EHRs.