Becoming deprofessionalized

Abstract

Negative impacts on the professionalization of staff nurses by the development and use of computerized nursing care plans are presented as a selected finding of a qualitative study. A symbolic interaction framework, using nurses' stories as communicated in semi-structured interviews, yielded meaning and behavior in metaphorical form. The computerized system for patient care planning, and the larger system in which it is embedded, contribute to loss of autonomy, loss of individualization of care, and loss of nursing expertise. Some questions that should be addressed now are identified.

Caring for Computers: The Hidden Work of Clinical Nurses during the Introduction of Health Information Systems in a Teaching Hospital in Taiwan

“…Also, performance of nursing tasks was sometimes delayed because of time-consuming and difficult-to-use system functions [29,35,36]. Nurses in one study perceived that the computerized nursing care plan and nursing record were inflexible and inappropriate [30], and other studies have suggested that electronic patient records were unable to support individualized patient care [37,38]. Using the computerized nursing care plan was documentation-oriented rather than patient-care-oriented and could not reflect patients' unique individual needs [27,30].…”

“…Furthermore, the impact of HIS standardization on nurses' professional competence was noticed [34,39]. Nurses perceived that nursing information systems limited their discretion to make professional judgements [27,37], impaired critical thinking ability [29,40], lessened autonomy [41,42], undermined nurses' ability to provide specialized individual care [30,38], and were unable to reflect "real nursing" [43], that is, nursing based on developing a one-to-one relationship with individual patients in order to assess their unique needs. Nurses thus perceived that computerization facilitated management control rather than improved nursing care [37].…”

Assessment study of the importance of computer technology in nursing health care

“…The use of computer technology provides quick access to important information about health or illness, Therefore record on the electronic health record personal health-care story, the treatments they carry out for, and response and progress toward health care goal for monitoring and for ready access by other team members,so that Information is significant at all levels of healthcare services, from patient and health unit management to policymakers, managers, and healthcare providers [10]. Nurses in one study perceived that the computerized nursing care plan and nursing record were inflexible and inappropriate [11], and other studies have suggested that electronic patient records were unable to support individualized patient care [12,13].…”