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Creating a Legacy: A Conversation Around Nursing Informatics
Episode

Tanya Lewis Strong, Nurse Informaticist

Creating a Legacy: A Conversation Around Nursing Informatics 

Let’s bring awareness to Nursing Informatics! We are honored to be joined in the Future of Global Informatics by Tanya Strong, a person near and dear to our host! 

 

Tanya talks about the evolution of the Nursing Informatics Industry and why it has been a challenge to legitimize the practice in healthcare. She discusses the importance of completing a master’s training in the subject over obtaining a certification. Tanya speaks of different avenues of work and several opportunities for a professional nurse informaticist, explaining each one and giving words of encouragement to pursue them. She also shares a little history masterclass of her professional path and the best advice she has to offer to future generations of nurse informaticist professionals.

 

Tune in to learn about the world of Nursing Informatics from an experienced Nurse Informaticist!

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Creating a Legacy: A Conversation Around Nursing Informatics

About Tanya Strong

Tanya Lewis Strong is a nurse informaticist and has been one since the late nineties. She has been in the military and in healthcare and has seen the evolution of medical records and nursing informatics from using monochrome monitors to the current coding and EMR systems. 

She has a bachelor’s degree and two master’s degrees, having been trained as a nursing informaticist. However, Tanya is also the mother and inspiration of TJ Southern, this podcast’s host. 

 

Future of Global Informatics_Episode 2_TStrong: Audio automatically transcribed by Sonix

Future of Global Informatics_Episode 2_TStrong: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

TJ Southern:
Hey y’all. Welcome to the Outcomes Rocket, the Future of Global Informatics podcast. Through conversations with industry leaders and innovators, we discuss global healthcare informatics so that you can understand what it does, what it is, and how it shapes healthcare of our future. I am your host, T.J. Southern. Let’s get started!

TJ Southern:
Alright, good day, y’all. This is your host, TJ Southern, and we are here today with the podcast of the Future of Global Informatics. Y’all know that I am totally excited about informatics, it’s my passion, it is my love, it is something that I absolutely am just wild about. And today I have another amazing guest, another amazing guest. I will let you tell her about, about herself, but she has a special place in my heart. She is one of my favorite persons in the whole wide world. We have Tanya Lewis Strong here with us today, Tanya Strong with us today. How are you doing today?

Tanya Strong:
Fabulous, fabulous. How are you?

TJ Southern:
I am excellent, I am excellent. So let’s get right into it because I’m telling you all like, I have one of the gurus of informatics here sitting with me today. So, alright, first question is, what actually got you into informatics? Tell the people a little bit about that, how you ended up in informatics.

Tanya Strong:
Well, patients, my patients inspired me to get into informatics. There’s nothing like an educated patient. And I feel like in order for patients to be educated, then their providers have to be educated as well. And that’s kind of what got me into the informatics realm, computers, just making sure that the patients have all the information that they need to make good decisions about their health.

TJ Southern:
So one thing that Tanya really didn’t explain about who she was and her background, can you give us a little bit about your background being in the military, being in healthcare, seeing the evolution of the medical record from that to civilian world?

Tanya Strong:
Okay, so a little bit about my background is I initially started in nursing when we were working on those dot matrix computers with the monochrome monitors, and that was back in maybe ’96. And all we used to do, all we did at that point in time was order labs in the system. And once we ordered the, because I have to say this prior to that, we had those chutes at each nursing station where you would handwrite the orders and put them in a chute, and then they would go off to the pharmacy, lab, radiology, that kind of thing. So that’s, that was my initial undertaking with computers moving from those little chutes where we would put the orders in and send those off to monochrome computers, monochrome monitors.

TJ Southern:
The tab tab x, where you had to tab tab x.

Tanya Strong:
Tab Tab x, yep, yep, and you had to decipher the doctor’s orders and put them in because they weren’t, they weren’t going to do all, any of that. So I started out with a bachelor’s degree and back then, of course, informatics was just a figment of someone’s imagination, I have to say, although it started, informatics started back in the sixties on the international realm. There were nurses publishing, writing stuff, but we kind of didn’t know where to put that information. So as time progressed, you know, we’ve gone from … all the way to where we are now with, I think it’s IM, IA, TJ, and correct me if I’m wrong.

TJ Southern:
Yeah, it is.

Tanya Strong:
But we have clinical informatics now where nurses are being published in journals and we’re all over the world. We have to say a lot of our brothers and sisters in China, they do a lot of publishing of research. So we’ve kind of, over the years, legitimized nursing informatics through our research and training staff and making sure that our patients have the correct information.

TJ Southern:
Man, let me tell you, you just gave us a whole history lesson in a nugget. So for many of you all who don’t know what informatics is, this is the beginning, right? When we, you know, many of us weren’t in that era where we had to chute. I can speak for myself, when I became a nurse, I was in the era where we still had paper charting, but we were starting to transition over to electronic charting. In some units you would still have this hybrid thing, right? Where they would have the charts. You would have to flip up to let the doctors know that, you know, or the doctor let you know that you had orders, and then only the labs were the thing that actually went into the system. So this is, the evolution of this has just been mind-blowing. And one thing that I can say, having Tanya here as a guest today, being able to have that background of where informatics really, truly came from, and just to see it be where it’s at now, you know, all of these years later is just, oh my god, it just makes my little heart flutter. So thank you so much for that history lesson on informatics. The biggest thing that I have or the biggest question that I ponder all the time is what are some of the biggest challenges or changes that you’ve seen in this industry, in the informatics industry?

Tanya Strong:
Well, and you know what? I have to say, our biggest challenge initially was legitimizing our practice for informatics. And it’s primarily because, you know, nurses, we can do anything, okay? We adjust to the situation and we adjust very easily and very good to situations. So administrators thought that they could pull nurses from the floors.

TJ Southern:
Yeah.

Tanya Strong:
They thought that by pulling nurses from the floors because we are trained in teaching, that we would be good teachers for anybody, and they were wrong with that and they found out over time that.

TJ Southern:
It wasn’t right, it wasn’t worth it.

Tanya Strong:
Yeah, that every nurse cannot be repurposed.

TJ Southern:
Yeah.

Tanya Strong:
So they started backtracking because what they were trying to do is make the nurses, pull the nurses from the floor and make them subject matter experts. And you and I both know it takes a little bit more than that to be a subject matter expert. And so the administrators, the CNOs, the managers themselves began to, I have to say, bark and complain because they were pulling their staff, and the staff were, were not wanting to be pulled because they weren’t getting any extra dollars for it.

TJ Southern:
Yeah, yeah, yeah.

Tanya Strong:
Not only the dollars, but they weren’t properly trained. And informatics training, we are taught all the different stages of learning, okay? We’re taught that some learning needs to be a hybrid. Some people are not trained or they have no computer knowledge at all. So that makes it a little difficult. I mean, and this, this, this was even a lot of our providers. They were moving to computers, kicking and screaming. They did not want to work on computers at all. So as an informatics nurse, you’re trained in healthcare management, you’re trained in peer review, you’re trained in evidence-based information, you’re trained in just working with different levels of education in people, okay? And myself, I have two master’s degrees, but how many nurses on the floor have that? Back then, back when I first started, we had graduate degree nurses. So, and a lot of them were LPNs that were godfathered in. So they didn’t, they didn’t have the level of education needed to train other staff members as well, and ancillary staff members as well. So we kind of had to go back to the drawing board and say, okay, so we need better-educated nursing informaticists, and we also need them to be able to train the staff to legitimize our practice. So we were required to have a bachelor’s degree, a master’s degree, and now certifications.

TJ Southern:
Yes, I can’t believe it, like, I cannot believe it.

Tanya Strong:
And sometimes, wow!

TJ Southern:
I know, I cannot believe it. I mean, even when I started in this industry, you know, almost 15 years ago, you know, there were only two schools at that time that offered MSN programs, only two for informatics. And you have to be careful which program you choose because you knew as a nurse, that’s one thing about nursing, nursing always has this progression of education, right? Where we, you tack on letters, alphabet soup. So you knew that there was going to be this certification coming somewhere down the line and you wanted to make sure that you went to a school that you could sit for certification afterward. So you had to make sure that you did your due diligence to make sure that your program could, that you could sit for board certification after the program. And now we have, where people just get certified as a Nurse Informaticist and they don’t even go through an MSN program anymore. You know what? I want to toss this question in there and ask you, do you really, in your years of practice, do you find that there is a difference between the certified nurse informaticist and the master’s prepared nurse informaticist?

Tanya Strong:
And there is, there is, because masters-prepared nursing informaticists, we get, those, that additional training. Whereas when nurses tried to, I have to say, jump the program and just go straight to the certification, they don’t have all the building blocks that we have as masters-prepared nurses. And, I have to say this, in my opinion anybody can take a test, okay? But it’s the information, the blocks that get you there that help the process.

TJ Southern:
Let me tell you, I agree with you 100%. Now, guys, we’re not discouraging you from getting your certification. We are really just giving you the honest truth. When you take a certification, you don’t have to go through all of the necessary steps that you have to go through as when you’re becoming or you’re going through a master’s program. You have time, you’re being baked in the oven, right? You’re learning things, you’re learning about the processes, you’re learning about how to educate. Like, you have all of these things. You even have a preceptorship at the end of your program that gives you a sneak peek into the world of informatics. When you take a, or sit just for a certification, you don’t get any of that, right? So you could really just be taking the certification blind and not really know what nursing informatics is, which PSA, many people do. They take the certification.

Tanya Strong:
I have to say, we as nurses, we’re trained to be able to jump in there and learn from that more seasoned nurse, and there are some things that I’ve seen and done that you have not seen and done, and there’s some things that you’ve seen and done that I have not seen and done. So our nursing practice is based on the knowledge that you get from your other nurses, that’s what nursing practices are based on. That’s why whenever you go into a new setting, you as a new nurse, you’re always partnered or preceptored with another nurse, a more seasoned nurse. So you won’t make the mistakes that she made or he made going into nursing, that’s the whole premise behind that. That you can learn from my mistakes. Let me say that. And without, with jumping in, taking that certification right away, I guess you can do that, but once you get that certification, you are put at a higher level. So once you start out into a practice, people expect for you to know stuff.

TJ Southern:
Already.

Tanya Strong:
Okay? And if you go into that practice and you don’t know stuff, then you’re setting yourself up for failure.

Tanya Strong:
Every time, every time.

Tanya Strong:
So those building blocks are there for a reason.

TJ Southern:
They’ll skip the process, y’all, don’t skip the process. So what current opportunities do you believe exist for the nurse informaticist?

Tanya Strong:
Oh wow. There are so many, so many opportunities out there for nursing, for nurses, nurse informaticists in this in this world. Healthcare is changing every day.

TJ Southern:
Rapidly.

Tanya Strong:
There there are a lot of areas in data analytics. There’s cybersecurity for nurses. Who knows a medical record better than a nursing informaticist? Okay, so who knows all the vulnerabilities better than a nurse informaticist? So what you, what nurse informaticists need to do, if I were a brand new, straight-out-of-school nurse informaticist, I would look at data analytics, okay? Learning how to build those reports. I don’t know how to build some reports myself, but there’s always the latest and greatest coding out there. HTML is old, so now there’s Python. There’s …, there’s Tableau. There is, there was another one I heard the other day. Shoot, I can’t remember it right now, but there are so many avenues out there. Population health is huge. People, these organizations are trying to lower their readmission rates. Readmission rates are costing organizations dollars. So if you can get those reports built and get them to providers so that they can get those patients in to be seen sooner, to catch illnesses, catch disease processes before they get to the full-scale range, lower risk, that is fabulous. And cybersecurity, that’s the other avenue. And I’m not talking about just dollars for nursing informatics. I’m talking about stuff that will take you, positions that will take you 10, 15, 20 years. As well as, you know, the old standard of building the applications and building medical records, that’s always an avenue as well.

TJ Southern:
I love the way that you said the old standard of building medical records because that’s what really the world sees us as nurse informaticists as, you know, it took us so long to legitimize our role within healthcare. Once we did, the world, they noticed us as, oh, well, they’re just healthcare or EMR, you know, builders, right? I mean, I cannot tell you how many times I got that, right? And I did. When I first started my career, I did, I built Cerner, I built the medication administration part. I built the lab part. I worked with mother-baby and built power … maternity. Power … maternity is actually my specialty. I built Allscripts, I built Athena. So I did, that was in the beginning of my career. But as my career progressed, there were so many other avenues that opened up for me and I decided to do project management. I decided to do that because there was so many projects that were being implemented and they did not have the right stakeholders at the helm to implement the projects correctly. So that’s how I ended up in project management. And you do, you have individuals that are going to data science, data analytics, report writing. You, like nursing informatics right now, you have your pick of the litter of what you want to do. The opportunities are so vast, right? But even in this same breath of, we’re telling you that the opportunities are vast, you got to be prepared for them. You got to know what it is that you can do and what is it that you can’t do and what is it that you’re wanting to do or you have this burning desire to learn to do? And I’ll be honest with you, informatics is not for everybody. There are a lot of people that I graduated with that have informatics master’s degrees that don’t work in informatics. They felt that it was boring, they didn’t want to do it, they didn’t feel so, those are the, that’s the other thing that nurses have to look at. You know, you’re going from working on the floor, dealing with patients, you know, sensory overload every day. So now you’re sitting at a computer by yourself, possibly having interaction with your team, just kind of here and there. But are you going to be okay with that? Being picked up out of that environment, being placed into this environment. And some nurses don’t like the transition. Some of them absolutely love the transition. Like myself, I can’t go back. This is me. I am a nurse informaticist at my core. So what do you think that we can do to better support the nurse informaticists that are transitioning from the floor, from all of these other arenas into informatics? What can we do to support them in their transition?

Tanya Strong:
Well, you know what? I think, first of all, their question to us should be, what’s a day in the life of a nursing informaticist? What does it look like? Before they start that transition, that is the first question they should ask. And us being nurse informaticists, we need to take them by the arm, by the hand and say, come walk with me. Because if they do that, maybe for a week, I would say walk with me for a week, because every day you see something a little different, okay? So don’t take just one day of me sitting there working on the computer all day being the all-to-end-all of nursing informaticists, because it’s not. We have a lot of times when you have emergencies, okay, where you have to be on it and you’re on the phone saying, what’s my ETA? When is it coming back up?

TJ Southern:
Yeah.

Tanya Strong:
When can I expect to get back in line? What do I need to tell these nurses? And we have gotten so used to computers and electronic medical records being the standard until when those computers go down, it’s an emergency, and it doesn’t happen all the time, but it does happen.

TJ Southern:
Yes, it does.

Tanya Strong:
So it might not happen the first or the second day that you’re taking that walk with me, but it might happen the third or the fourth day. And we might be working 18 hours that day trying to get that system up, going from floor to floor to floor, making sure they have everything they need to take care of those patients.

TJ Southern:
Downtime forms. Yes, ma’am.

Tanya Strong:
Alright, so one day might be boring, but the rest of it is not. Let me tell you, there is always something going on in the realm of nursing informatics. You just have to be there. And reports, if you’re building a report for somebody, then you have to go over it with them step by step and make sure it’s correct. And they might want it that day, the same day they tell you, they assign it to you, they might want it back that same day. So that could be an emergency, okay? And then you have different state entities coming in inspecting. And who do they want to go with them but you? Because you know the Electronic Medical Records.

TJ Southern:
Yes, ma’am. You know the EMR.

Tanya Strong:
Yeah, so every day is not a piece of pie every day.

TJ Southern:
Man, that’s good, that’s good. So now, we’ve had this whole entire conversation about nursing informaticists and I can tell the passion in your voice as well as you can tell the passion in my voice, but we both know that here I am 15 years later, here you are, almost 20-something years later, and people still don’t know what a nurse informaticist is.

Tanya Strong:
Yeah.

TJ Southern:
No. What do you think needs to be talked about more in order to bring awareness to this role and to help organizations understand that they truly do need us?

Tanya Strong:
Well, and you know what, I think it starts with our partners. Our partners being physicians. They need us, and whether they like it or not, that medical assistant in their office that they call a nurse is not a nurse. So they are part of the group that can continue to legitimize our practice and bring us along and say, hey, I really need that nurse informaticist right here. I was working at a hospital, UF Health, and we had a nurse informaticist that had become a physician, and she really brought us along, respected nurses, respected nurse informaticists. She made sure that the nurse informaticists were trained, that they were not pulled straight from the floor and given a position. So I think, I think the goals for nurse informaticists, both international and worldwide, should be getting those physicians to come along with us in this, in this realm and continue to legitimize nurses, nurse informaticists. That’s a huge factor that will help.

TJ Southern:
That is amazing. So I’m going to let y’all in on a little secret, right? Tanya is my mom. She actually was the one who pushed me into nursing informatics. I remember I had finished my nursing degree and I knew that I had to have advanced education, but at that time it was I could get an MBA, I could do nursing education, I could be a nurse practitioner, and I didn’t want to do any of those. I did not want to do any of those. And I remember her and I having this conversation. I was in my home and I was just like at my wit’s end, and she said, have you thought about informatics? I said informatics? What is that? Like, I don’t know what that is. And she said, well, do some research on it and let me know what you think. And I did, and I was like, oh my god, it was almost like she was giving me this secret pathway, this secret doorway. And when I tell you, I jumped in with both feet and it absolutely changed my life. It is the one aspect of nursing that I must say that I am absolutely in love with. I will be a nurse informaticist until I cannot peck on a keyboard anymore.

Tanya Strong:
Good for you, congratulations. That’s a good thing.

TJ Southern:
So I have not only one of the grandmothers of informatics, but my mother as an informaticist and a colleague in arms. So trust me and understand that I understand that I am truly, truly fortunate to have a mentor and a leader like her so close at hand. So I thought it would be a treat for everyone to actually meet her and hear her point of view and her thoughts and just the wisdom that she can give all of us. So thank you, Mommy, I appreciate you.

Tanya Strong:
Thanks for having me.

TJ Southern:
Alright, you got any parting words? Any final thoughts for us, informaticists, new and informaticists that have been in the game for quite some time, do you have any parting words for us?

Tanya Strong:
Just don’t get discouraged because a lot of times when you’re out there working that 12-hour day, we have a tendency to get discouraged. If you go on in cybersecurity or data analytics, just take it one step at a time. You can build those reports. You can do it.

TJ Southern:
That is awesome. Well, thank you so much for the encouragement, so thank you guys for joining us today for another episode of The Future of Global Informatics, where we discuss and we talk with influential leaders in the informatics realm so that we can educate you on informatics. Now, if you’re happening to be looking for informatics talent, please, please, please go to www.beryllus.net. That is www. B E R Y L L U S .net and we can assist you with finding some of the best nursing informatics talent this continent has to provide. We will talk to you guys later. Thank you so much for your time. Have a great day. Bye-bye.

Tanya Strong:
Bye-bye.

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Things You’ll Learn:

  • Three different avenues of work opportunities for professional nurse informaticists are: data analytics, cybersecurity, and building medical records.
  • A current issue in the nursing informatics industry is picking nurses who are working on the floor and trying to make them informaticists without the proper training. 
  • Getting physicians to incorporate and legitimize nurse informaticists can be the first step to legitimizing the practice altogether in healthcare.
  • Every day is a new adventure in the nurse informatics realm. 
  • Not everything a nurse informaticist does is working behind a computer, there are days in which they are called to hands-on tasks. 

 

 

Resources:

  • For more information on topics related to informatics or on finding talented informaticists for your organization, please visit the Beryllus Website