Letter to the Editor
Article Outline
To the editor:
Some months ago, in an issue devoted to the topic of nursing informatics, McBride and Detmer editorialized on the state of the specialty in practice today.1 While emphasizing the need for informatics, they lamented that “nursing faculty still do not know what or how to teach in this area” and that “most nurses remain disinterested,” and they asked “why is [nursing informatics] still invisible?” The essence of their question seemed to be: We've been moving in this direction for a long time—why aren't we there yet?
The answer, I think, boils down to the failure of nursing to make nursing informatics real to practicing nurses. McBride and Detmer (repeating the observations of many others) bemoaned the equating of technology with informatics. Technology is real, it can be seen, manipulated, and used in the daily work life of the nurse. Technology makes obvious contributions to nursing practice. Informatics, on the other hand, may make an invaluable contribution to nursing science, but remains an abstraction with little relevance to the practice of the clinical nurse. The practicing nurse may make accidental use of nursing informatics through use of the electronic health records (EHR) and personal study of issues related to his/her practice, but, for that nurse, informatics as a science and a discipline is likely to carry little meaning.
Part of the solution, obviously, is to make informatics more meaningful for the average nurse. This begins with incorporating the term into our regular professional language. Personally, I don't know if I'd ever even heard the term informatics discussed until well after starting into my current Masters program (nor am I unique among my colleagues in this respect!). Even then it remained a “so what?” concept until just recently. I'm only now beginning to understand the concept, and I still struggle when asked to describe what it means (ie, what it “looks like”) for those whose boots are on the ground. We need to start talking about informatics at the most basic level, telling our nurses and nursing students “this is how to access the information, this is informatics,” or “using the EHR is one facet of informatics,” and so on. Familiarity with the term is the first step to familiarity with the concept and use of the discipline in daily practice.
This, of course, starts with academic faculty and nursing development staff. Unfortunately, many of these—as ample research shows—are not much further along than I am. When the number of nursing faculty who consider themselves to be competent in nursing informatics practice (37%) is still outweighed by novices and advanced beginners (13% and 26% respectively), it's obvious that there are problems in academia.2 Just as clinical nurses have trouble realizing nursing informatics, nursing faculty have trouble fitting it into the syllabus and making it come to life in the classroom. Without a concerted effort to bring faculty up to speed and help them integrate informatics into the curriculum, the acceptance arc for nursing informatics is likely to mirror that of nursing diagnoses.
As noted above, there have been few concrete descriptions of what nursing informatics looks like in practice. In other words, there remains a notable absence of a clear operational definition. While informatics goes beyond information communication technology (ICT) conceptually, as McBride and Detmer noted, in actual practice informatics always does involve ICT (personal communication, L. Ornes, March 12, 2009). For an operational definition, I therefore suggest that we might reach back to Graves and Corcoran3 and describe nursing informatics as any practice that makes use of ICT to access, retrieve, utilize, and/or communicate healthcare information within the context of nursing practice.
What is nursing informatics and why isn't it more quickly becoming a vital part of nursing practice? I am clearly one of the novices, and can barely answer those questions for myself, much less anyone else. With time, and with the willingness of nursing informatics specialists to view the issue from the perspective of the typical nurse, we might find a way to make it happen.
Thank you.
References
- . Guest editorial: Using informatics to go beyond technological thinking. [editorial] Nurs Outlook. 2008;56:195–196
- . Headlines from the NLN. Informatics in the nursing curriculum: A national survey of nursing informatics requirements in nursing curricula. Nurs Educ Perspect. 2008;29:312–317
- . The study of nursing informatics. Image: J of Nurs Schol. 1989;21:227–231
PII: S0029-6554(09)00056-6
doi:10.1016/j.outlook.2009.04.002
© 2009 Mosby, Inc. All rights reserved.
