Elwha supervising me at the keyboard.
In high school I took typing for dummies. I was terrible at it and slow. Many women were avoiding typing classes in the late 1970s because they did not want to be secretaries. I wanted to be a writer and knew that I was a terrible typist. I also could not spell my way out of a paper bag. My mother was quite dyslexic and did not care. Once I had to sound out a word at the store from her grocery list: “LETIS”. Oh. Got it. Her letters are wonderful, not only interesting and creative spelling, but also wandering tenses and subjects.
We got our first electronic medical record in the early 2000s. We went from looking up labs on a computer and using a computer for maybe an hour total per day to full on eight hours a day. My shoulders and the nurses’ shoulders all locked up and we all filed for Workman’s Comp. I had to work with physical therapy to get my shoulders to unlock. My nurse pointed out that all problems were treated as “User Problems”. That is, WE were the problem, not the program. I realized that having the doctors who love computers pick out the program, learn about it for a year, and then teach us in two days and go live was a massive mistake. None of us understood it nor did we understand any of the computer lovers’ terminology. We rapidly quit asking questions because we didn’t like being treated as morons. Every person who was not a computer lover figured out their own work arounds. Two years later, the computer lovers tried to get us to standardize what we were doing. It’s not very surprising that we resisted and hated them. We had had to figure it out on our own with no help and we were very cynical and disbelieving that they would now “Make it easier.” Nope, they didn’t.
If I were to do it over again, the team picking the electronic medical records would include a couple of older doctors who hate computers. One of the selling points to the computer lovers was “you can write your own templates”. Our response was “We would rather be boiled in oil.” Three years after we got the system I asked the head computer lover doctor to write me a template. It was generic. Patient is complaining of (a problem) (more than one problem). The (problem) has been present for (a day, two days, a week, a month, a year, too long). The problem is (getting worse, the same, getting better). And so forth. Because we had all sorts of problems that did not have a template. My computer lover doc rolled his eyes, but set it up for me.
I also asked the clinic CFO WHY they didn’t set up typing lessons for the doctors who couldn’t type. I watched one of our group hunt and peck with two fingers. “You want them faster, right? You’ve said we could do the whole note in the room. How can they if they can’t type?”
“We are not giving them typing lessons.”
“Well, I think that’s misguided.” Ok, what I meant was that I thought it was STUPID.
Another selling point was that we could finish the note in the room. It turned out that I could do the note in the room after I had fought with the program for two years. It consistently took me 25 minutes. Then they ramped up the schedule and set us all at 20 minute visits. I started running late all the time. I told the front desk, “I’ve been told I should get the note done so I am. And if it takes me 25 minutes, that is what it takes.” Once the hospital kicked me out, I started my own clinic and did 30 minute visits. This did not make me rich but it made me a heck of a lot happier.
For the Ragtag Daily Prompt: keyboard.
My oldest sister took typing in high school. I think it was required for girls. (She is 77 years old.) I don’t even know if it was still offered when I got to high school a few years later. Boys definitely weren’t supposed to be there. My mom took a night school course and I used her book to try to teach myself. When our hospital introduced Epic I became a “SuperUser” and was assigned to wear a special shirt and be available for over-the-shoulder training. One ortho doc tried to make me his personal assistant. When I asked another doc to sign in to show me the problem he was having, he ran his finger across the number row – that was his password. For my last several years I was able to dictate notes and use voice recognition to do the typing (another Superuser pilot project, which became less effective when they eliminated small offices and crammed people shoulder-to-shoulder in shared rooms to write notes). I just had to proofread for weird errors. I found out the hospital paid someone to read all dictated notes, as I received a monthly report listing all of the notes they had read and approved, or any typos they found. That didn’t happen with typed notes, so they somehow knew which notes used voice recognition. “Point-of Service” documentation just means your focus is on a computer screen instead of a patient – a lousy idea that I fought until the day I retired.
We used A4 first. My solo clinic used amazing charts. The hospital went to Epic after A4.
We used “PC Shorthand” before we went to Epic.