Tracking Devices Anger Nurses

As Mr. Spock prepares to be transported, he touches the Starfleet badge on his chest and says, "Beam me up, Scottie!" In the familiar sci-fi scenes from Star Trek, Scottie always knows the location of Mr. Spock. Scottie's futuristic capability will soon be another management tool to control nurses in hospitals and nursing homes around the country when tracking badges are introduced this year.

Far from being amused, some nurses are furious.

"Nurses are being reduced to the status of criminals," says Christina Terranova, a former SEIU union steward and member of the Internet-based nurses' organization, The Florence Project. "Do they tell doctors to wear those damn things? No, only nurses and nurse aides lumped in with equipment! This is degrading and it's discrimination."

The new devices, currently in the second phase of field testing, are used to track nurses and equipment with tags and badges that carry a unique code for each person or piece of equipment.

Infrared light from battery-powered badges is "detected by receivers installed throughout the facility," according Wescom, a company that markets the devices. The system can "provide real-time and historical information on the location of any item [or person] it is tracking." Supervisors can receive printouts on the location of any of their staff at any time. "This makes it easy to find people or equipment at any time of the day or night, provide real time location of equipment, patients, and staff as they move around the hospital," the company says.

Other workplaces that are targeted, according Wescom, include banks, warehouses, and prisons.

Nurse administrators like the systems. They point to their ability to monitor the time it takes to answer a patient call, which could increase patient satisfaction. Tagged equipment can be found easily. In addition, a staff member who is threatened can activate a button on the badge to summon help quickly.

UNION BUSTING TOOL

The systems can also be used to bust union organizing drives and weed out whistleblowers. They can capture data from all over the health care facility, which can then be analyzed to provide a "map" of the activities of employees during their shifts.

During a union organizing drive, it would be important for management to know who the organizers are. Mapping the workplace could give them answers. The data would show that a certain person was detected on a certain unit and the time as well. Distributing flyers would be more difficult, especially if the tracking device was combined with security access swipe cards that control access to certain floors.

"The positive uses of the tracking system will be used to sell it to the staff," predicts Mike Parker, an expert in new computer-based technology. "Because of understaffing, there is tremendous anxiety about being able to handle difficult situations. Fewer staff means fewer eyes and ears to help when staff members are in jeopardy. One incident of the rape of a nurse and management can sell the whole system to frightened employees."

Parker says that one way to counter the negative effects of the tracking devices is to demand that unionized staff oversee the programming of the computers to determine if dossiers are being kept on employees. Unions can bargain the scope of the systems to make sure no one is disciplined." Non-union staff, however, has little chance to change or stop the introduction of the tracking systems.

OOPS!

Some nurses and aides, without a union to back them, have taken a page from Luddite history. A nurse who wishes to remain anonymous, and whose hospital has used an older badge system, reports that employees dropped the badges in patients' bedpans, lost them in the toilet "accidentally," or forgot to wear them. Management's response, of course, was been to charge the nurses as much as $250 to replace "lost" badges.

Another argument that is raised in support of these systems is that they capture data on the uses of the nurse's time that could be used to argue for more staff. "A well integrated system would be a lot more efficient at documenting our shifts," says Andrew Lopez, a Mantua, New Jersey nurse entrepreneur and former medical surgical nurse. "Nurse managers will be able to address the patient acuity vs. staffing concerns of the nurses more effectively. The only real measurement that we have of our workload is where we spend our time. With accurate measurements, it would be easier to justify the need for extra staff and demonstrate the acuity of our patients."

However, Grant Tomlinson, a computer information specialist nurse in Toronto, disagrees. "I would suggest that the idea that nurses are simply task performers has led to trends that are hazardous to nurses and patients," he says. The trends that he names include mandatory overtime; widespread floating of nurses into areas that they are not prepared or qualified for; and excessive use of unlicensed assistive personnel.

According to Tomlinson and other nurses, the underlying assumption in all these trends is that nursing is a series of tasks and anyone can learn to do tasks. Most nurse researchers and nursing theorists reject this simplistic view.

"The essence of nursing is individualizing care specific to the needs of the patient," says Barbara Tracy, an emergency department nurse in New York. "Knowing when a patient is about to crash, analyzing signs and symptoms, assessing the whole patient--this is nursing. A person trained to do rote tasks can't do that."

Rosanne Chiachi, a member of the e-mail list, Nursenet, is livid about the tracking devices. "Would you judge the success of open heart surgery or the ability of the surgeon by the "correct" amount of time that the surgeon spent in the operating room? she asked during a recent discussion of the issue on the internet.

"You can't judge nursing as if it were an assembly line," adds Terranova.

A version of an older tracking system is already installed in at least 137 health care facilities throughout the U.S. In an effort to inform union members and the public about these monitoring systems, a group of nurses has started The Surveillance Monitoring Team.