Nursing, IT, and the Law:  Three Passions in One!

DIANE TOMACELLI, RN, BSN

 

Being a nurse opens up a world of opportunities I did not know existed when I started out.  I have been an RN since 1987.  There have been so many changes in healthcare and the profession of nursing over the years, it is difficult to keep up with where it began for me.  I remember changes happening that are considered commonplace now such as utilization of PCA pumps.  (Patient Controlled Analgesia) It was such an exciting time when we started using the PCA for our orthopedic patients and they did not have to experience an IM injection every time they needed pain medicine.  Another example is when we started doing what was referred to as “auto-transfusion” for orthopedic cases.

Those changes were challenging and exciting and scary all at the same time.  Every time something new came along, the research, training, and implementation were necessary for success and not always welcome to be added to the daily challenges.

I remember that I was not always happy with the changes and that I also experienced fear and insecurity about whether I could learn and do everything correctly.  I loved what I did and it took me some time to become used to the everchanging world.

I look back over the 30 plus years and realize I have had so many opportunities and I have grown from each one.  In every step of the way, I have always focused on “accountability” and have been fascinated with the legal side of healthcare.  I have also always been drawn to tv series on forensics or ones that showcase the medical examiners.  Yes, for those of you that are old enough to remember the show Quincy……. I loved it!

I remember my early years of nursing, I worked with 2 other RNs that were married to lawyers and one of those nurses (Julie was her name) taught me a lot about making sure my charting not only had all the pertinent data for being able to make clinical decisions, but also covered all the information needed in case of a law suit.  I loved listening to her talk about the possibilities of medical malpractice litigation.  She fed my need for talking about the law and litigation and watching Quincy took care of the forensic addiction. 

Now with legal nurse consulting, I can feed both of my passions for nursing and the law.  I cannot state enough the vast number of opportunities and directions a degree in nursing can take you and I believe I have found my niche.  I combined my nursing career with aspects of the law and also threw in IT (information technology) just for fun.

I have a great deal of experience with clinical information technology and find that I want to build my LNC business focusing on this area.  Being a nurse requires that you learn the logistics of healthcare because at times a nurse has to do all things.  (The Nursing Process covers all possibilities) Knowing healthcare logistics, on top of the clinical knowledge is priceless in assisting attorneys with their cases.  Being an expert on the logistics of EHR (electronic health records) adds valuable skills for working with attorneys. 

I love being a nurse.  I have been very blessed working in a profession that I love.  I am doubly blessed that this profession that I love is more of a calling and also offers endless opportunities for growth and development.  I can feed my passion for the law alongside my passion for helping others.  I do recognize that healthcare is not perfect even though we try to be.

One of the areas where healthcare could improve is in policing its own.  Do not misunderstand, there are many policies, guidelines, regulations, practices, and procedures in place to monitor and review the practice of all levels of clinical practitioners.  I just feel that the data that is obtained is not always “acted on” because of a lack of the ability to “prove” that an action or lack of action caused an issue or the fact that many practitioners travel from state to state while any issues remain behind because they were not reported.  Issues have to be reported to enable someone to track those issues.  There are several stories that have been in the news where a healthcare worker has had repeated issues but went from state to state and years passed before their issues were discovered. 

Healthcare entities try to make sure that each person that enters their facility to work or consult on a case has a clean background check and a level of competency to ensure safe patient care.  That is where again, if something was not reported, it cannot be found.  Ensuring that the practitioners are competent is only one aspect of providing safe healthcare.  Competent practitioners can also make mistakes.  There are many factors involved, way too many to discuss in this article.

Even the best of practitioners makes mistakes.  At times there is a very high level of stress and pressure that all adds up to an environment that is ripe for mistakes.  Add the urgency and need to rush into that mix and work can sometimes be difficult. Sometimes everything is done right, but we still have a bad outcome.  We deal in the human condition and there are no absolutes.

I find myself wanting to work on all sides of the issues.  First, we work on quality and prevention.  When lawsuits occur, we work either with the plaintiff or with the defense.  I do not have a preference of “which side” I am working on.  I choose to work on quality, prevention, reviewing and explaining the medical records while also identifying the standards of care that apply in the given situation. I am passionate about each one of those areas and am blessed to work as a nurse where I can have a role in each one as well. 

Right now, with healthcare, we are overrun with COVID patients and keeping our staff healthy.  Protecting our patient and staff is of the utmost importance. We also keep looking beyond COVID and work to maintain our quality care during this challenging time.  As we begin 2022, I know we will have another roller coaster ride for healthcare this year and I look forward to sharing it with you!

Until next week.  Please stay safe and well !!

Diane T

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