Do You Know Where Your Nurse Is?

 

Who wears a tracker during their time inside that can locate them wherever they are and the time that they spend in any given location in real-time?

If you said criminals on house arrest, you’d be right. But if you said licensed nurses you’d also be right.

Hospitals use technology, also called RTLS (Real-Time Location Systems), in order to track nurses everywhere in a hospital.  This is not required of the physicians, physical therapists, EKG techs, radiology techs, secretaries… but it is required of the nursing staff.

That’s right.  Nurses and nursing aides are located every single minute from the moment that they arrive on their floor (or any floor, for that matter).  Even supply contractors and security guards are not treated with such scrutiny.  Despite being surrounded with hundreds of thousands of dollars of goods while being in possession of potential weapons, those unlicensed personnel are not required to wear trackers.

But nurses, registered nurses, and patient care technicians (PCTs, PCAs, or CNAs) who are also certified and undergo federal background checks that include fingerprinting of all fingers upon licensing (and renewal) all are.  Anywhere that one of these members of the staff go, the administrators can pull up data.  Were they in the patient’s room at noon when they said?  How long were they in there?  Where did they go?  Wait.  How much time exactly are they in the break room?  How long did it take them go travel the hallway to the supply closet?

Of all the licensed professionals in the world, nurses are being tracked for the veracity of their statements and for “performance improvement”.  Like our pieces of equipment, we are undergoing “asset management”.  We are being tracked and managed every single moment that we are in the hospital.

We are being tracked in order to cross-reference and verify our statements about patient care.  We were in the room?  Yes?  Confirmed?  Okay.

We are being tracked for “performance improvement”.  How much time did we spend in the room?  Was it too long?  Was it enough?  Was it at the correct time?  Was a bedside report done?

The websites say that it is all about metrics and bettering nursing care, making it easier for the nurses.  Indeed, there are some things that are easier; when one walks into the room directly under the patient’s bed the nurse call light will turn off automatically as it senses the RN in the room.  It gets rid of touching a button on the wall.

But ultimately, it is about money.  It is about tracking nurses.  It is about nurses being assets themselves.  The time that nurses spend not performing duties or charting is a cost.  Therefore, it is necessary to ensure that costs are controlled.

Nurses are regularly called while on the toilet.  My apologies for going there, but I will.  Nurses are called regularly.  If the phone isn’t answered, they’re called incessantly over and over and over.  They receive texts and pages.  Sometimes, the leadership will look for the last known location, will see that it was the break room, then stomp into the bathroom to find the person they so desperately need whether or not they’re on the toilet.  Indeed, legal restrictions stop them from putting sensors directly in the bathrooms themselves, but there’s an intercom on the wall in the breakroom and there’s a sensor in the break room.

Think about this and let it really, really sink in.

All other licensed professionals in the hospital are allowed to perform as they must.  They still have a phone and are reachable.  They often must log where they are, when they’re leaving a floor, etc.  However, they do not have a tracker that records their every move as well as the duration of that move.

It is not just the indignity of it.

It is that they sell it to the hospitals under the guise of performance improvement.  They expect the nursing staff to jump right on board and be enthusiastic, even, about being tracked.  Every. Single. Moment.

It isn’t about performance or about a legal CYA (though it can be sometimes).  It is about knowing where your assets are at any given time.

And nurses are the largest asset at any hospital.

It is no surprise that there is a march on the Capitol planned for May.  I am only surprised that nurses had this much patience and endurance.

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  1. HankRhody Freelance Philosopher Contributor
    HankRhody Freelance Philosopher
    @HankRhody

    TheRightNurse: It is that they sell it to the hospitals under the guise of performance improvement.  They expect the nursing staff to jump right on board and be enthusiastic, even, about being tracked.  Every. Single. Moment.

    One of the fascinating things about this moment in history is that we’ve rapidly developed the ability to gather, collate, and weaponize so much data about people that it’d make even the most obsessive stalker blink. Not specific people; everybody. Because it might come in handy. One thing I’m hoping to see come out of this moment is a broad cultural understanding of what it’s okay to monitor about people and what’s not. 

    In the meantime I’m sorry to hear that you’re in the experimental group. 

    • #1
  2. EDISONPARKS Member
    EDISONPARKS
    @user_54742

    I have to wonder if the nurse tracking device wasn’t the invention of a philandering Doctors wife looking to bring in the heavy ammunition in order to win big in the divorce settlement.

    …. Just kidding ….

    Ridiculous actually …. insist the Doctors have to wear one as well and that should put the end to it.

    • #2
  3. Blondie Thatcher
    Blondie
    @Blondie

    I and here I thought the stupid Vocera phone thing that I had to wear was bad. It also has the function of tracking, but the person with it has the ability to turn the whole thing off. I got all spun up yesterday talking about the current brewhaha surrounding what travel nurses get paid. You are right. It is a wonder that we’ve endured this for so long.

    Edited to add: That Vocera thing was one reason I gave for retiring early. It is an interruption to patient care. I didn’t like the path we were/are going down.

    • #3
  4. Kozak Member
    Kozak
    @Kozak

    Kaiser tested those when I was working there in the 90’s.  The nurses would put it on a sweater and just drape it over a chair leave it there all shift.  Since they were a union shop, Kaiser couldn’t do anything about it until they could get it in a new contract.  

    • #4
  5. Kozak Member
    Kozak
    @Kozak

    EDISONPARKS (View Comment):

    I have to wonder if the nurse tracking device wasn’t the invention of a philandering Doctors wife looking to bring in the heavy ammunition in order to win big in the divorce settlement.

    …. Just kidding ….

    Ridiculous actually …. insist the Doctors have to wear one as well and that should put the end to it.

    Until very recently most doctors were not actual hospital employees.  So no.  Not gonna be tagged like a deer.

    • #5
  6. Kozak Member
    Kozak
    @Kozak

    Blondie (View Comment):

    I and here I thought the stupid Vocera phone thing that I had to wear was bad. It also has the function of tracking, but the person with it has the ability to turn the whole thing off. I got all spun up yesterday talking about the current brewhaha surrounding what travel nurses get paid. You are right. It is a wonder that we’ve endured this for so long.

    Edited to add: That Vocera thing was one reason I gave for retiring early. It is an interruption to patient care. I didn’t like the path we were/are going down.

    Wanted the doctor to wear one in the ED. I just said no.  Constantly being interrupted while trying to get a history or examine a patient,  or in the middle of a procedure when I’m gloved up, problematic for HIPPA. When I worked an ED shift I never left the department. If they needed me that bad, they could find me.

    Ditto the request we bring a laptop into the room and chart while interviewing the patient.  Nope.  Patients hate it.  I can’t concentrate on my history, eye ball evaluation of the patient ( a huge deal in making a diagnosis and deciding on a course of action).    Scribe’s work much better ( if you get a good one, and most were good, many trying to get into med school or PA school).  But scribes cost money.

    • #6
  7. Blondie Thatcher
    Blondie
    @Blondie

    Kozak (View Comment):
    problematic for HIPPA

    This was my biggest complaint about the thing when we got it. I was told, “you tell the person calling you that you can’t talk or you step out of the room.” Yeah, right. Like that’s gonna happen. A friend of mine (also a former nurse) was in the hospital with a family member last year. She said by the time he went home, she knew everything about every patient on that floor because of the Vocera. I complained incessantly about it before I left. Fat good that did. 

    • #7
  8. Kozak Member
    Kozak
    @Kozak

    Blondie (View Comment):
    This was my biggest complaint about the thing when we got it. I was told, “you tell the person calling you that you can’t talk or you step out of the room.”

    Yeah, so you step into the hallway. Like thats a private space.

    • #8
  9. Blondie Thatcher
    Blondie
    @Blondie

    Back to the tracking part, I’ll have to ask the still working crowd if they are being tracked. There was talk of it before I left, but it was all hush-hush. Sort of like the government. We do things to you that you just don’t know about. 

    • #9
  10. EDISONPARKS Member
    EDISONPARKS
    @user_54742

    Kozak (View Comment):

    EDISONPARKS (View Comment):

    I have to wonder if the nurse tracking device wasn’t the invention of a philandering Doctors wife looking to bring in the heavy ammunition in order to win big in the divorce settlement.

    …. Just kidding ….

    Ridiculous actually …. insist the Doctors have to wear one as well and that should put the end to it.

    Until very recently most doctors were not actual hospital employees. So no. Not gonna be tagged like a deer.

    Think of it more as scientists studying the mating habits of the medical community.

    • #10
  11. Judge Mental Member
    Judge Mental
    @JudgeMental

    EDISONPARKS (View Comment):

    Kozak (View Comment):

    EDISONPARKS (View Comment):

    I have to wonder if the nurse tracking device wasn’t the invention of a philandering Doctors wife looking to bring in the heavy ammunition in order to win big in the divorce settlement.

    …. Just kidding ….

    Ridiculous actually …. insist the Doctors have to wear one as well and that should put the end to it.

    Until very recently most doctors were not actual hospital employees. So no. Not gonna be tagged like a deer.

    Think of more as scientists studying the mating habits of the medical community.

    Close, but not quite enough to get the cigar.

    As a data guy, this seems like a fairly straightforward attempt to combine the various types of data capture into the equivalent of the old Time and Motion studies done by factory efficiency experts a hundred years ago.  They’re going to match what you’ve charted and billing-scanned the patient for, with the time spent in the room, and determine if you spent 11 minutes cleaning up puke and changing a bed when their stats say that should have only taken 8 minutes.

    Those stats can then form the basis for performance evaluations.  Bonus, discipline, termination.  The goal will be to have you almost running at all times, both you and the patient be damned.

    • #11
  12. Blondie Thatcher
    Blondie
    @Blondie

    Judge Mental (View Comment):

    Those stats can then form the basis for performance evaluations.  Bonus, discipline, termination.  The goal will be to have you almost running at all times, both you and the patient be damned.

    DING! DING! DING! And what do we have for our winner, Johnny? Not a dang thing. 

    • #12
  13. The Scarecrow Thatcher
    The Scarecrow
    @TheScarecrow

    My god that sounds hellish.

    We all marvel at the services and conveniences modern life provides, and we’ve all come to expect it, in shopping and all the stuff we’ve been conditioned to do online. And certainly in our health care – maybe this more than anything else.

    Reading your post makes me realize the cost of all this, not only to our privacy and dignity, but to our humanity. 

    Reading @kozak above, I got a little flash about a doctor (maybe it was him) pointing out once how much of a doctor’s whole skill – his whole job, really, his effectiveness – lay in simply observing the patient, talking to him. I’m sure it is similar with a nurse, as she tends to his daily needs while he heals. But that’s all gone in modern pharmaceutical-based and profit-driven medicine.

    To deliver what we’ve all come to expect today, in medicine and in all areas of modern commerce, we have all been increasingly turned into machines. Both providers and customers.

    Humans aren’t machines. That is kind of the point. God could have simply made little machines and set the whole little toy in motion and it would go on clacking away indefinitely. But we’re something else.

    I think we’ve made a bad bargain here.

    • #13
  14. Kozak Member
    Kozak
    @Kozak

    The Scarecrow (View Comment):
    Reading @kozak above, I got a little flash about a doctor (maybe it was him) pointing out once how much of a doctor’s whole skill – his whole job, really, his effectiveness – lay in simply observing the patient, talking to him. I’m sure it is similar with a nurse, as she tends to his daily needs while he heals. But that’s all gone in modern pharmaceutical-based and profit-driven medicine.

    I can’t stress this enough.  From the minute we walk into the room we are assessing the patient.

    When I talk to him I can tell instantly about his mentation, breathing, level of distress. It’s one of the reasons I have to tell family to let the patient answer the questions. At least during my initial assessment. Later they can chime in.  But not during the first few minutes of the interaction.   Thats why I hated anything that would detract from that, either charting on a laptop for ” efficiency” or carrying a damn phone. 

    Ditto the nurses. A smart doctor will listen to his nurses if they tell him there’s a problem with the patient.  They saved my bacon all the time.

    Unfortunately, we are now the captives of the Clipboard Mafia, and they want everything nice and neat, protocol driven, no thinking allowed. And trying to squeeze every last drop out of the staff. No time to eat, pee, chart, think.

    Just keep “moving the meat” through the department.

    • #14
  15. Fake John/Jane Galt Coolidge
    Fake John/Jane Galt
    @FakeJohnJaneGalt

    EDISONPARKS (View Comment):

    I have to wonder if the nurse tracking device wasn’t the invention of a philandering Doctors wife looking to bring in the heavy ammunition in order to win big in the divorce settlement.

    …. Just kidding ….

    Ridiculous actually …. insist the Doctors have to wear one as well and that should put the end to it.

    I doubt it.  Doctors are getting to be just another employee.  They should be expecting to be treated the same as the others. 

    • #15
  16. Stad Coolidge
    Stad
    @Stad

    TheRightNurse: Nurses are regularly called while on the toilet.  My apologies for going there, but I will.

    The next time you get a call in the john, make sure the caller hears the flush . . .

    • #16
  17. Fake John/Jane Galt Coolidge
    Fake John/Jane Galt
    @FakeJohnJaneGalt

    This desire to track employees at all times has been breaking out in business from before the pandemic.  The pandemic just made it more desirable and like many things forced years of development in months.

    Many of the people I know that work remote from their companies have been getting tracked for a while now.  This is especially so the lower you go on the org chart.  Managers have to manage and this is their tool so they can have solid metrics.  Being in IT I have been around many of these initiatives.  Personally I feel that they are misguided in that they are trying to use technology to solve a management problem but we now live in the world of lawsuits and affirmative action so these metrics have value for management and especially HR that really likes to use this stuff for hiring, firing and promotion decisions.

    Many delivery companies have cameras on their trucks that record the driver, inside the truck (driver), forward and backward facing, maybe surrounding the truck as well as GPS and telemetry data that is accurate to 30 seconds.  These systems usually have cards or phone apps so the driver is tracked separate from the truck.

    About anybody that is doing phone support is having metrics recorded.  Number of calls, call lengths, how many return calls of clients, surveys for every interaction, recording of person either by cameras at work site or via computer cameras facing them when working from home.

    Many professionionals I know are required to be available 24/7.  Most either use their own smartphones or has one provided for them.  To connect these systems to their company’s email require agreements to load company authorized software that tracks all sorts of info about phone usage, location, even recording of personal stuff.

    I expect this stuff is just going to get worse as the ability to track continues to grow and cost continues to decline.  Especially since society has went from a “my info is my business” perspective that was my generation to the “look at me world, know all of me” perspective that seem to becoming the new norm.

    • #17
  18. Fake John/Jane Galt Coolidge
    Fake John/Jane Galt
    @FakeJohnJaneGalt

    Stad (View Comment):

    TheRightNurse: Nurses are regularly called while on the toilet. My apologies for going there, but I will.

    The next time you get a call in the john, make sure the caller hears the flush . . .

    Done that.  Nobody cares anymore.  

    It used to be that we had a business presence and they still give lip service to it but I have been in too many zoom meeting with babies, kids, pets, etc. while watching people sleep, scratch parts of their body and pick their nose.  It seems even masterbation on a zoom call is no longer a fireable offense and to think it is shows that you are closed minded.  Our culture has lost the sense of privacy and the expectation of it.  

    • #18
  19. The Scarecrow Thatcher
    The Scarecrow
    @TheScarecrow

    Fake John/Jane Galt (View Comment):
    Our culture has lost the sense of privacy and the expectation of it.  

    And more than just privacy. Any sense of seemliness. Dignity.

    Part of it is waaaaaaaaaaay too much interaction with each other. The constant communication, always having to have an opinion, all of us talking at the same time about the small doings at some Walmart in Muncie, or something a teenager said on TicTok, or a car accident in Terra Haute. 

    It all becomes meaningless; the things that do matter, should matter, to each of us are lost in the frantic scramble to stay plugged in. Huxley was right.

    • #19
  20. Mark Camp Member
    Mark Camp
    @MarkCamp

    For an employer to treat his employees in such a degrading way is deplorable to me. The people who are guilty of it should be held accountable and stopped.

    • #20
  21. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    It is part of the overall trend to see human beings as machine parts and no more 

    Health Care systems are pretty evil in their executions. We will all end up paying for it. 

    • #21
  22. Fake John/Jane Galt Coolidge
    Fake John/Jane Galt
    @FakeJohnJaneGalt

    Mark Camp (View Comment):

    For an employer to treat his employees in such a degrading way is me. The people who are guilty of it should be held accountable and stopped.

    Why?  We are all resources now.  Just like a book, a laptop or a meeting room is a resource.  The only reason we have a job is because we are the least cost way to get our process done.  As soon as there is a cheaper way that is what will be done and we will be removed.  

    • #22
  23. TheRightNurse Member
    TheRightNurse
    @TheRightNurse

    Stad (View Comment):

    TheRightNurse: Nurses are regularly called while on the toilet. My apologies for going there, but I will.

    The next time you get a call in the john, make sure the caller hears the flush . . .

    Oh I do. 

    • #23
  24. Fake John/Jane Galt Coolidge
    Fake John/Jane Galt
    @FakeJohnJaneGalt

    TheRightNurse (View Comment):

    Stad (View Comment):

    TheRightNurse: Nurses are regularly called while on the toilet. My apologies for going there, but I will.

    The next time you get a call in the john, make sure the caller hears the flush . . .

    Oh I do.

    Not sure how it is in the lady’s room but in the men’s room talking was forbidden but now there seems to be a cell phone exception.   It is amazing how much info you can find out there now while sitting on the can. 

    • #24
  25. HankRhody Freelance Philosopher Contributor
    HankRhody Freelance Philosopher
    @HankRhody

    Blondie (View Comment):

    Back to the tracking part, I’ll have to ask the still working crowd if they are being tracked. There was talk of it before I left, but it was all hush-hush. Sort of like the government. We do things to you that you just don’t know about.

    There’s a report somewhere that adds up all the hours I spend on Ricochet on company time. There’s a timeclock I punch to let them know I’m on the premises. There are security cameras in the building but none pointing at my desk. At a handful of doors in the place I have to scan my badge to enterI write notes about my night’s activities (I’m a support tech) which among other things let people know I’m doing things. I carry a hip phone at work so that people can get a hold of me.

    To my knowledge there’s no tracking of my position in the building. They could reconstruct it with old fashioned police work; talking to people, noting time stamps on my ricochet comments, watching twelve boring hours of security footage to see if I walk by that particular camera, that sort of thing. 

    To my knowledge there’s also no productivity monitoring software measuring my actions per minute at my workstation. Maybe my Ricochet comments per hour dropped because I’m busy in a spreadsheet or maybe my snores are disturbing the folks nearby. 

    • #25
  26. HankRhody Freelance Philosopher Contributor
    HankRhody Freelance Philosopher
    @HankRhody

    Blondie (View Comment):

    Back to the tracking part, I’ll have to ask the still working crowd if they are being tracked. There was talk of it before I left, but it was all hush-hush. Sort of like the government. We do things to you that you just don’t know about.

    Oh, right, I work in a cleanroom. The company that cleans our cleanroom smocks has an RFID tag in the collar it uses for tracking the smocks as it cleans them. We tell new people that those are what the company uses to track their location on the floor, to see if they’re spending too much time hanging around the cute girl on the Solvent Developer. They never buy it.

    • #26
  27. HankRhody Freelance Philosopher Contributor
    HankRhody Freelance Philosopher
    @HankRhody

    The Scarecrow (View Comment):

    To deliver what we’ve all come to expect today, in medicine and in all areas of modern commerce, we have all been increasingly turned into machines. Both providers and customers.

    Humans aren’t machines. That is kind of the point. God could have simply made little machines and set the whole little toy in motion and it would go on clacking away indefinitely. But we’re something else.

    I think we’ve made a bad bargain here.

    When you sell your soul to the devil you not only lose your soul you also never get the other end of the bargain. The devil is tricky like that. 

    All that big data they use doesn’t give us our packages faster; it gives us slightly more targeted advertising. I can live without targeted advertising. 

    • #27
  28. Fake John/Jane Galt Coolidge
    Fake John/Jane Galt
    @FakeJohnJaneGalt

    One of the side effects to working in IT is that I deal in data and legal a lot.  It is amazing how many companies have hidden cameras everywhere.  Sadly the camerias mostly have PTZ which is ran by security guards.  More than once I have known of issues because the security guards use the cameras to look down women dresses / blouses.  Everything has issues and when you farm this out to the lowest cost resource you get games played.  

    • #28
  29. HankRhody Freelance Philosopher Contributor
    HankRhody Freelance Philosopher
    @HankRhody

    Fake John/Jane Galt (View Comment):
    I expect this stuff is just going to get worse as the ability to track continues to grow and cost continues to decline.  Especially since society has went from a “my info is my business” perspective that was my generation to the “look at me world, know all of me” perspective that seem to becoming the new norm.

    You’re the kind of guy who sees the tide going out and assume the oceans are draining, aren’t you?

    Right now that’s the direction we’re going. We won’t end as machine parts in a cyberpunk zaibatsu though. Don’t assume the answer a tween girl gives you as to why she posts every meal pic on instagram is the answer she’ll give you ten years later in the workforce. Letting her friends know everything is one thing. Letting her boss know everything is another. 

    Look at the Right Nurse; her job here has a lot of really crappy things going on with it, largely lack of support from the management and a “you’re a nurse, handle it” attitude where they expect her to handle problems that should be theirs. People will put up with a certain amount of unfairness. After that they stop playing the game by the given rules. That’s how unions got their start. Sooner or later The Right Nurse is going to get fed up and walk out; the only reason she (and all the other nurses) haven’t walked out is they’re nurses, which all come with an overdeveloped duty complex.

    TheRightNurse: It is no surprise that there is a march on the Capitol planned for May.  I am only surprised that nurses had this much patience and endurance.

    • #29
  30. Chuck Coolidge
    Chuck
    @Chuckles

    What!!

    Is this just on the Left Coast or is it nationwide?

    Is this ALL hospitals – nationwide??

    Color me speechless.

    • #30
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