CHRISTINA FEAK, RN BSN CNOR
Director of Clinical Informatics
St. Lukes Hospital ~ Maumee, OH
My name is Christina Feak and this is a day in my professional life. I am a Registered Nurse (RN), with a Bachelor’s of Science in Nursing (BSN) degree, as well as a certification in Operating Room Nursing (CNOR). I am the Director of Clinical Informatics at St. Luke’s Hospital, a community hospital located in Maumee, Ohio. I have been at St. Luke’s for nearly 8 years and have had my current position for 2 ½ years.
The Clinical Informatics position at St. Luke’s was brand new when it was posted in April, 2007. Among the responsibilities listed were facilitation of strategic clinical information technology direction to support excellence in patient care; clinical process evaluation and transformation; evaluation, selection, building and implementation of new Health Information System (HIS) for all clinical areas; and development/implementation of educational programs to assure proficiency in clinician use of computer technology. When I saw the posting and reviewed the expectations, I knew immediately that it was my dream job.
BACKGROUND, EXPERIENCE, AND HOW I GOT HIRED:
So what would lead an Operating Room nurse to consider a switch to Clinical Informatics? Over the years in which I worked as an OR nurse, OR nurse educator, OR Manager, and OR Director, I was leading a double life. Starting in 1992, I spent evenings and weekends exploring the expanding online world. The daughter of a Systems Analyst/Programmer, I had a great deal of curiosity about the direction computer technology was going. With my increasing interest and increasing time online, I found it to be expensive to pay the hourly fees that the various companies, such as Prodigy, America Online, and Compuserv, charged. The only way I could continue this exploration was to volunteer for those companies, which then developed into actual employment with one of them. I learned how to program and how to build and manage message boards and chat rooms. I was able to teach others these skills in an online college, and found myself hosting medical chats as a freelancer for several websites. Building communities was the goal and I was very fortunate to have the opportunity to learn and practice the skills to do so.
Computers began to make their way into my workplace a little at a time and I was one of the few nurses who was excited about the possibilities. Because of this, I volunteered anytime there was an opportunity to do something in the hospital that had to do with computers. I was called upon to help with determining clinical needs, evaluating vendors, assisting in selection, and became involved with implementing the systems and educating the users. I found myself thinking seriously that this was the ultimate direction I would like to pursue in my career. To me, it was the best of two worlds that I really cared about: nursing and computers. I read everything about the informatics field that I could get my hands on. Unfortunately, I wasn’t able to find an actual position to do this, so continued my work in the OR. Fortunately, I really love the operating room so this was not a hardship.
This brings us back to that day in April, 2007, when the job posting went up at my hospital. As OR Director I had a wonderful job that I loved, with terrific people with whom I enjoyed working every day. On the other hand, here was what I had been looking for, right at my own institution. I was one of three applicants and I worked extra hard in preparation for the interview. As part of this effort, I reviewed the Nursing Informatics Standards of Practice, reviewed all components of the TIGER initiative, and compiled information related to my hospital and online experience with computer technology. I was never so nervous as I was for this interview, which was conducted by the Computer Information Services (CIS) Director, Manager of CIS, Special Projects Manager of CIS, and the Vice President of Patient Care Services. I was on pins and needles waiting to hear what decision was made and was beyond thrilled when I was offered the position. I consider myself extremely fortunate to have been in the right place with the right skills to make this career move.
A DAY IN MY LIFE:
I’ve been in the role now for 2 ½ years and have never yet had what I would consider a “typical” day. In some ways, I view my main job as that of an interface, facilitating bi-directional communication between the clinical and technology worlds. The CIS staff may find a request from clinical users to be unrealistic, and wonder why they would even ask such a thing. I am able to help them understand why the request matters to clinicians. Nurses may feel frustration when they don’t know why the computer team can’t just make the computer do everything they want. I am able to help them understand the reasons why there may need to be other ways to accomplish the goals.
Among the biggest, and most exciting, challenges is that of replacing our current electronic documentation system(s). We’ve spent the last year evaluating a variety of systems, and ended the year having made our selection. As we move ahead with this project, I’m leading a team in process mapping the patient and information flow throughout the continuum of care. While this project is a major focus, day to day operations need to continue, including support of our current systems. In all of this, it is crucial to remember the ultimate goal – safe, high quality patient care.
On any given day I may find myself participating in activities as diverse as working with the CIS team on downtime processes, answering an email from an upset nursing supervisor who was using Excel and “lost” her toolbar, reviewing the information and applications needed on the nursing supervisor laptop, collaborating with a systems analyst on an Access database into which performance improvement data will be entered , and revision of the interdisciplinary care plan to make it easily translatable into an electronic format. I find it invaluable to have a sense of humor and I make it a practice to include fun in every single day. I even had the opportunity to give a presentation to key members of the Marketing department on the use of social media (Facebook, Twitter) in healthcare!
These activities are truly just the tip of the iceberg; but this is a blog, not a book! While I will always consider myself a surgery nurse, I’m very glad to have made this transition into informatics. In some ways I get to have my cake and eat it too, as I am very involved in the electronic documentation opportunities in the perioperative areas, in addition to the other clinical areas. I remain a member of the Association of periOperative Registered Nurses (AORN) and keep my certification current. I’m working on a Masters of Science in Nursing (MSN) degree, and hope to pursue a post graduate certificate in Nursing Informatics.
If you want to move in the informatics direction my best advice for nurses already working in a healthcare facility is to volunteer for anything you can related to computers in your facility. Be the super-user in your department when the new computer system comes along. Offer to help others who may be intimidated or uncertain about computer use. Make suggestions regarding how computers might provide efficiency and value to your co-workers; share those ideas with the people who can make it happen. Before you know it, you can be one of them yourself.
Nurses working in non-hospital environments can aim for informatics in a similar way as those in hospitals; get involved in anything and everything related to computer technology in your workplace. Ambulatory EHRs are huge right now, so find out where your facility stands on the subject, and participate in the decision-making process to work toward achievement of meaningful use and those stimulus dollars. Again, focus on keeping things patient centered; that’s why we’re here in the first place!
And my advice to those of you who are new nurses, or are just about to finish nursing school and head out into the workplace, is a little different. Get some good solid clinical experience, as that is the most important attribute you can bring to the table when making a move toward informatics. In my experience, and as I’ve been told by Information Technology professionals, you can take a clinical person and teach them about computers; it’s not as easy to take the computer person and teach them to be a clinician. That’s not to say that there aren’t any number of computer professionals who have gone back to school for nursing, pharmacy, etc., and been extremely successful. The informatics colleagues with whom I interact are generally clinicians first.