I’ve mostly found that smart alerts just overreact to everything and result in alarm fatigue but one of the better features EPIC implemented was actually letting clinicians (like nurses and doctors) rate the alerts and comment on why or why not the alert was helpful so we can actually help train the algorithm even for facility-specific policies.

So for instance one thing I rated that actually turned out really well was we were getting suicide watch alerts on pretty much all our patients and told we needed to get a suicide sitter order because their CSSRS scores were high (depression screening “quiz”). I work in inpatient psychiatry. Not only are half my patients suicidal but a) I already know and b) our environment is specifically designed to manage what would be moderate-high suicide risk on other units by making most of the implements restricted or completely unavailable. So I rated that alert poorly every time I saw it (which was every time I opened each patient’s chart for the first time that shift then every 4 hours after; it was infuriating) and specified that that particular warning needed to not show for our specific unit. After the next update I never saw it again!

So AI and other “smart” clinical tools can work, but they need frequent and high quality input from the people actually using them (and the quality is important, most of my coworkers didn’t even know the feature existed, let alone that they would need to coherently comment a reason for their input to be actionable).

No plan survives first contact with the enemy.

Actually it is. There’s not actually a nursing shortage if you look into the numbers, there’s just a shortage of nurses willing to get screamed at by delirious people while doing backbreaking work without backup or enough people to distribute that work among while getting paid pennies. If so many people weren’t leaving the field entirely due this issue (the chief complaint ALWAYS being under-staffing / low nurse-to-patient ratios, THEN pay), there would be plenty of nurses to go around. It always comes down to pay and ratios (which are inextricably intertwined) and everything else is fractions of percentages of the problem that get overemphasized so that the people siphoning money out of this system never have to address the elephant in the room. Don’t let them deflect you away from focusing on their greed. A bunch of nurses are also out there pushing themselves through degree mill nurse-practitioner schools to become wildly unsafe prescribers for the same reasons as those leaving entirely, which also reduces the bedside workforce.

Right now we’re just trying to keep the ANA from making functionally illegal to go on strike in the first place by making it our fault for “patient abandonment” if the hospital doesn’t hire (usually extremely expensive) travel nurses to cover strikes.

The way strikes work for nurses is that hospitals are essential to a community, so you have to give notice, then the hospital has to find temps to cover (again, I’m fine with this, I don’t consider them scabs, their wages alone are punishing the hospital, but this is also why they shouldn’t be capping travel salaries). The issue is they’re trying to make it so that it’s the responsibility of the nurses going on strike to find that coverage, or they get charged with abandoning the patients. They’re literally just trying to make it functionally illegal to even go on strike without ever saying those exact words.

They’re taking comments right now, let me find the link. Here’s the r/nursing post that person said it all better (I’ve been trying to get more hcw communities going over here but it’s slow going and feels like it’s only me sometimes. Here is a sample comment (but it’s written from a nurse perspective, it may need to be shuffled around into “concerned citizen” language) and here is the direct link to the survey. If one of you wants to draft a solid “concerned citizen statement” I’ll add that too.

Could also make a good post on c/medicine or c/antiwork but idk I’m still waking up and have a lot of unpacking from the move still to do this weekend. But it may actually help them to know people outside the Healthcare sector are starting to notice their bullshit. Or that Healthcare CEO money will still be too good, idk.

They have badge attachments now that beep and tell your supervisor if they don’t sense a nurse washing their hands or using hand sanitizer when they enter a room. I get the idea for how this could lower infection rates in hospitals but I wonder if maybe it’s not just more humane to just hire more nurses and encourage us to take time to do things correctly instead of essentially fitting us with a shock collar that does everything but the actual shock.

They’re doing shit like this and people still ask why they have to put up nets to catch people jumping off the parking garage like it’s some kind of mystery.

They also have little wand sensors that you have to go into a room and put up to a receiver for psychiatry to ensure we’re actually physically going into all patient rooms every fifteen minutes 24/7 even while they’re sleeping to make sure they’re not hanging themselves in there. Honestly sometimes it feels like we’re just making sure they want to hang themselves by the time they leave.

This libertarian redneck does! I also like taxing the ever loving fuck outta billionaires so they can’t mess with muh freedums. I also absolutely love this bit because a) it’s 100%FAX and b) my neighbor across the cul-de-sac actually did get caught breeding illegal reptiles.

Like Enron, LOL.