DIGITIZING: SEARCHING FOR THE RIGHT BALANCE

Digital monitoring is not just widespread in the ‘hard’ sectors. Monitoring is also commonplace in health care. At the Wit-Gele Kruis home care organisation, the electronic nursing file (EVD) is the digital hub for the nurses on the road.

Union secretary Rik De Jaeger explains that the EVD contains all the information about the patient, but also about the actions undertaken by the nurse. He has seen digitisation grow over the last couple of years.

“It certainly wasn’t all better in the past,” he laughs. “Much of the administrative paperwork has disappeared, overtime is more clearly visible, the nurses’ knowledge has increased, the quality of health care has improved …” But there are downsides as well. “Or risks that we need to keep an eye on.”

Fair coaching

Rik has no knowledge of any explicit abuse – but employees are sometimes suspicious about what is registered and saved. “Managers are fair in their handling of that data. They primarily use EVD data for coaching rather than for checking. The management is also more moderate than before, when everything had to happen ever faster. That’s also due to the shortage on the labour market. It’s becoming increasingly difficult to find and retain nurses. And in that case, an approach that’s too harsh has the opposite effect.”

“Employees aren’t systematically reprimanded if they’re working at a slower pace than the average according to the data, or if their hand sanitizer lasts longer and they therefore perhaps do not disinfect their hands sufficiently. The data collected can lead to an interview, but that was also the case in the past.”

Soul

But claiming that monitoring only has positive consequences is also a bit short-sighted. “Nurses have told us that digitisation is gnawing away at their job satisfaction. It takes the soul out of their work. Everything they need to do, is listed in the EVD. But nurses can and want to assess what is needed themselves. Sticking to strict schedules is not always satisfying. Patients don’t like it either that the nurses are looking more at the screen than at them.”
Nurses often check their EVD immediately when they wake up. “Sometimes literally on the edge of their bed”, says Rik. “Because they can see what’s ahead of them, how long their day will be and which extras are added to their package that day in the EVD. Because the pressure is on. Sometimes the EVD also provides a bit of online training. Which means that more work is transferred to private time.”

The future

“The planning engine, which a while ago fully automatically scheduled the nurses’ rounds, has been stopped for the time being. The planning tuned out to be too complex for the machine. Management has taken over again until the planning engine has been improved and can work autonomously again. We’ll have to wait and see if that works.”

And there is more to come. Pilot projects with smart glasses are currently underway. “They’re glasses that project information that helps the nurse during complex treatments. A head nurse can then also watch from a distance. Experiments are also being conducted with apps that remotely read out patients’ blood or sugar values, for example. These are all developments that have a significant impact on the nurses’ jobs.”
The trade union would like to address this issue. “But we have noticed that the management doesn’t think it’s that important. They only inform us when the new technology is already operational. So there is still some work to be done there.”