Advice » In the Workplace» Workplace Issues » Communication Tips for Nurses W ...
Communication Tips for Nurses When Electronic Health Records Enter the Exam Room

Communication Tips for Nurses When Electronic Health Records Enter the Exam Room

Three’s a crowd, so what can nurses do when they find a computer alongside their patients in the exam room? Are communication and patient care doomed to suffer when electronic health records (EHRs) replace paper charts? Not necessarily.

“For our inpatient nurses, using electronic medical records is a very new concept,” says Mary Jo Williams, RN, regional director of Kaiser Permanente Medical Group (Northern California) Nursing and Clinical Practice. Kaiser Permanente (KP), the nation’s largest nonprofit healthcare system, is in the midst of a massive, multiyear initiative to establish EHRs for all of its 8.5 million members.

So far, at least 70 percent of KP members have at least some of their records on the system; all members’ records will be fully on board by 2008. EHRs are winding their way through every part of the KP health system -- all 32 hospitals and medical centers as well as more than 430 medical offices. To help orient nurses in the use of EHRs, KP is providing both extensive classroom instruction and on-the-job practice.

Practice Makes Perfect

With any new system, it’s important to become as proficient as possible before going live with patients. For example, users of EHRs that require typing could bone up on weak keyboarding skills. Since most EHRs require users to complete templates, it’s best to familiarize yourself with the format beforehand so you can focus on the patient, not the screen.

“But the biggest challenge for nurses is often not learning the new computer application, but rather its integration into their workflow,” says Judy Murphy, RN, a fellow in both the American College of Medical Informatics and the Healthcare Information and Management Systems Society. At Milwaukee-based Aurora Health Care, Murphy led the EHR implementation, which involved bringing computers to patient rooms and nursing stations in all 14 Aurora hospitals.

Since many Aurora facilities rely on portable computers, nurses now wheel a computer around on a cart. They build their assignment sheet differently and have learned to chart differently, but their job of providing patient care remains unchanged, Murphy says.

Build Communication

How can nurses maintain patient-centered care while using EHRs? Follow these tips:

  • Begin by Establishing Rapport with the Patient: “Instead of walking right to the computer when entering an exam room, greet the patient and listen to their concerns,” suggests Sara Kooienga, FNP, assistant professor in the advanced nursing program at Oregon Health & Science University. Kooienga, who researched exam room communication and EHRs when she was with the Providence Health System, suggests it may help to review notes from the previous visit before you enter the room.
  • Maintain Eye Contact: Try never to turn your back on a patient. That’s easier when the computer is on a cart, on a properly angled counter or attached to an arm. Maintaining eye contact is especially important when discussing sensitive issues.
  • Get the Patient’s Approval: Before you start entering data, explain what you’re doing and ask for the patient’s permission, just as you would do before touching a patient for a physical exam, suggests Williams. Ask, “Do you mind if I enter some of this data while I’m talking with you?”
  • Explain Yourself: Don’t sit silently staring at the monitor, scrolling through screens or endlessly clicking. Tell your patients what you’re doing while you’re doing it, suggests Kooienga. Try to keep talking as you work.
  • Involve the Patient: Chart in the exam room if you can involve the patient in some way, says Williams. Otherwise, you might be better off jotting down notes while you’re with the patient and entering the data afterward.
  • Tap the Teaching Potential: EHRs can display patient data in a way that has great visual impact, such as charts and graphs that show trends in blood pressure for heart patients or insulin levels for diabetics.

By following these tips, nurses can turn an exam room computer from an intruder into an ally.

Latest Jobs

Logan Electric Service, Inc.
Posted: 05/30/2015
Fredericksburg, VA, 22408
Posted: 05/30/2015
North Smithfield, RI, 02896
Next Level Associates
Posted: 05/30/2015
Lyndhurst, NJ
Pacific Technical Resources LLC
Posted: 05/30/2015
Houston, TX
Next Level Associates
Posted: 05/30/2015
Hackensack, NJ

Want more personalized results?  Update Your Profile


Monster Communities

Teaching Community
Where teachers meet and learn.
Create and connect.
Networking for the career-minded woman.
Nursing Link
Where nurses call the shots.
More Monster Communities

Monster Partners

Scholarships, financial aid and more ways to pay for school.
Find top campus and online degree programs.
Military portal for the US Army, Navy, Air Force, Marine Corps and Coast Guard.
Financial Aid
Scholarships & financial aid.
Staffing for Government Jobs
Staffing and hiring solutions for federal government agency jobs.
More Monster Partners

Job Hunt Strategy

Six Ways to Make a Recruiter Hate You
If you want to blow your chances with recruiters -- and, by extension, with the companies they work for -- here are six perfect ways to do so.

Resumes & Cover Letters

Rev Up Your Resume to Relocate
Hoping to relocate? Get the ball rolling on landing the right job in the right location with these expert resume and cover letter tips.


100 Potential Interview Questions
Interview questions can run the gamut. You probably won't face all 100 of these, but you should still be prepared to answer at least some of them.

Salary & Benefits

10 Questions to Ask When Negotiating Salary
Most of us aren't natural negotiators, but asking these 10 questions during salary negotiations can help you get everything you deserve.

Employee Sourcing

Alt text
November Monster Employment Index Grows 13% Year-Over-Year, Tenth Consecutive Month of Positive Annual Growth.

For Seekers

Campus and Online Degrees
Advance your career and earn more with an online degree.
Free Salary Wizard
What are you worth? Find out and negotiate a better salary.
Research Careers
Get information on jobs and career paths to help guide your choices
Questions & Answers
Find answers to all your career related questions -- powered by Yahoo! Answers
Resume Distribution Service
Our distribution service puts your resume right in the hands of recruiters.
Resume Writing Services
Our experts will craft a keyword-rich resume that stands out in the crowd.
More Career Resources

For Employers

Career Ad Network
Target your job posting to more candidates on thousands of websites.
Hire Right Background Checks
Explore our background check packages to improve the quality of your hires.
Hiring Home Page
Find the best candidates for your business with Monster hiring solutions.
Job Postings
Find the right solution for your hiring needs. Starting at $99.
Power Resume Search
Monster's new search technology precisely matches people with your jobs.
Resource Center
Find staffing insights, labor trends, HR best practices and more.
Target Post
Connect with skilled, hourly and administrative candidates for only $99.

Social Media

Jobs on Twitter
Find jobs in your area and industry.
Monster Careers
Tune into our career advice and discussions tackling a wide range of topics and industries.
Monster Corporate & PR
Stay up-to-date on the latest news. Get the 'Who', 'What', 'When', and 'Why' on all things Monster related.
Monster Customer Service
Got a Monster question? We've got the answer. Whether you're a job seeker or employer, we can help you find the answers you need.
Monster for Employers
Find advice on hiring.
Follow Us
Check out our many pages and stay connected with the latest industry news, events, career advice and job openings.

Other Links

Monster Company Profiles
Explore companies and get information to guide your career decisions.
Compare Salaries
See how your pay stacks up to others in your field.
iPhone Application
Download the Monster app for iPhone and iPod touch.
Monster Job Seeker Blog
Monster Job Seeker Blog.
Monster Thinking Blog
Monster's Recruitment Trends Blog.
Jobs & Career Resources
Search Jobs:
For Employers: Post Jobs | Search Resumes | Advertise
About Monster | Work for Monster | Advertise with Us | AdChoices | Partner with Us | Investor Relations | Social Media
Terms of Use | Privacy Center | Accessibility Center | Help | Security | Contact Us | Sitemap | Mobile
©2015 Monster - All Rights Reserved U.S. Patents No. 5,832,497; 7,599,930 B1; 7,827,125 and 7,836,060 MWW - Looking for Monster Cable? - V: 2015.8.0.34-210