Is floor nursing experience necessary for Informatics Specialist job?

[cbutler]

I am a BSN completion student researching Nursing Informatics Specialist. Our hospital has information specialist but I do not believe they are certified or labeled as such. I was wondering if most places require floor experience for this type of job. I personally think it would be beneficial to have the experience driven nurse in charge of electronic record development.

[rwingo]

I would say "yes".

Most nursing informatics job descriptions that I have seen have required a minimum of 3 years, preferably more.

There is a lot about nursing workflows and processes that you can only understand by actually "doing it."

In looking at Benner's 5 stages of clinical competence, she's defined 2-3 years of nursing practice as being consistent with being a "Competent" nurse.

Stage 3: Competent
Competence, typified by the nurse who has been on the job in the same or similar situations two or three years, develops when the nurse begins to see his or her actions in terms of long-range goals or plans of which he or she is consciously aware. For the competent nurse, a plan establishes a perspective, and the plan is based on considerable conscious, abstract, analytic contemplation of the problem. The conscious, deliberate planning that is characteristic of this skill level helps achieve efficiency and organization. The competent nurse lacks the speed and flexibility of the proficient nurse but does have a feeling of mastery and the ability to cope with and manage the many contingencies of clinical nursing. The competent person does not yet have enough experience to recognize a situation in terms of an overall picture or in terms of which aspects are most salient, most important.

IMHO, a "competent" nurse could surely function as part of a team implementing an EMR, but I don't feel that the "competent" nurse would have the necessary experience to step into a "nursing informatics specialist" role.

Also, IMHO, I think that the best bets for "good" nursing informatics specialists would be in seeking out nurses that could be considered "proficient" or "expert" nurses as they should have a very good understanding of nursing workflow, nursing theory, and good real-world experience to draw from.

Again, based on Benner's research, it looks like a minimum of 4-5 years of nursing practice is what's needed to get to the proficient or expert stage in most cases.

Stage 4: Proficient
The proficient performer perceives situations as wholes rather than in terms of chopped up parts or aspects, and performance is guided by maxims. Proficient nurses understand a situation as a whole because they perceive its meaning in terms of long-term goals. The proficient nurse learns from experience what typical events to expect in a given situation and how plans need to be modified in response to these events. The proficient nurse can now recognize when the expected normal picture does not materialize. This holistic understanding improves the proficient nurse's decision making; it becomes less labored because the nurse now has a perspective on which of the many existing attributes and aspects in the present situation are the important ones. The proficient nurse uses maxims as guides which reflect what would appear to the competent or novice performer as unintelligible nuances of the situation; they can mean one thing at one time and quite another thing later. Once one has a deep understanding of the situation overall, however, the maxim provides direction as to what must be taken into account. Maxims reflect nuances of the situation.

Stage 5: The Expert
The expert performer no longer relies on an analytic principle (rule, guideline, maxim) to connect her or his understanding of the situation to an appropriate action. The expert nurse, with an enormous background of experience, now has an intuitive grasp of each situation and zeroes in on the accurate region of the problem without wasteful consideration of a large range of unfruitful, alternative diagnoses and solutions. The expert operates from a deep understanding of the total situation. The chess master, for instance, when asked why he or she made a particularly masterful move, will just say: "Because it felt right; it looked good." The performer is no longer aware of features and rules;' his/her performance becomes fluid and flexible and highly proficient. This is not to say that the expert never uses analytic tools. Highly skilled analytic ability is necessary for those situations with which the nurse has had no previous experience. Analytic tools are also necessary for those times when the expert gets a wrong grasp of the situation and then finds that events and behaviors are not occurring as expected When alternative perspectives are not available to the clinician, the only way out of a wrong grasp of the problem is by using analytic problem solving.

For additional references, you may want to take a look at the job descriptions listed on ANIA's nursing informatics roles page as well as our list of Job Descriptions in our Informatics Job Description Database.