Informatics Nurse, Taofiki Gafar-Schaner

[00:01] Michelle: I have to admit, before speaking with Taofiki Gafar-Shaner, I had very little knowledge of Informatics nursing. And he was terrific at giving us a window into this interesting nursing specialty. Taofiki's knowledge of the role is apparent. And he taught us much, from how electronic health records are built, to the vulnerability of these records to cyber attacks, from what kind of schedule to expect, to the education required. I think the most important lesson he taught us is just how to be a good human. As a nurse informaticist, he is a nurse advocate of the highest level, improving nursing workflows and even co-inventing a product that benefits nurses in the care of their patients. And there's no better human than that, one that helps nurses, help patients. In the five-minute snippet, we learned he feels teachers are the most undervalued profession, and he would be right. Here is Taofiki Gafar-Shaner. You're listening to the conversing nurse podcast. I'm Michelle, your host. And this is where together we explore the nursing profession one conversation at a time. Well, hello, Taofiki. Welcome to the show.

[01:29] Taofiki: Hello there. Nice to be here.

[01:32] Michelle: It's so nice to have you. Ever since your friend and mine, Kathleen Wardell, introduced us, I've been very excited for you to come on because your field of nursing is completely foreign to me, except for a teeny tiny part, and we'll get to that. So I'm so interested and I'm going to be learning right along with everybody else. So thank you again for being here.

[02:01] Taofiki: My pleasure. It's always fun chatting with you people.

[02:05] Michelle: So the way I like to do things is I just jump in with the question that you've been asked probably a million times, what is an informatics nurse?

[02:18] Taofiki: Yeah, I get asked that often. An Informatics nurse, for lack of a better term, there's the fun answer and the boring answer. The current boring answer is that nurses in charge of making sure that the things that a nurse uses, whether it be at the bedside or outside the bedside, whether it be hardware, whether it be software, is optimized for what they need to do their job. And currently, that is mainly focused around the EHR. So whether it be Epic, Cerner or etc. It's making sure that those tools are as good as they need it to be, or even those tools are as good as we needed for reporting to the state or reporting to federal agencies on what nurses are doing. And so that is the answer that I think most people define what nurses are doing today, Informatic nurses are doing today. And for me, the more exciting answer is figuring out how nurses work and how we can take that to the next level when it comes to patient care and not just focusing mainly on hospital care.

[03:30] Michelle: So you had explained the boring part, which wasn't so boring, but go ahead and tell me about the fun part.

[03:43] Taofiki: The part of informatics that excites me is what we are going to be doing or what we should be doing in the next 15 to 20 years, as opposed to focusing primarily on the EHR system and focusing within the hospital, it's what are we going to be doing for patients? When you look at things such as the ECG devices in our wearables and all the other things that are going on in the consumer market, how can those things apply to patients and how can nurses make sure that those tools are optimized for patient care? Those tools are optimized for preventative care, and not a lot of informatic schools are talking about these things and not a lot of healthcare systems are putting nurses in jobs that look at these things. And to me, that's a full-blown industry on its own that is not being tapped. And that's kind of what excites me is that if we had the right tools outside the hospital, we can prevent diabetes and CHF patients and our dialysis patients from getting worse, and then they don't end up in the hospital for five-plus days. So that's what really excites me.

[04:46] Michelle: Well, that's a lot, that's really exciting. So you obviously have to be a nurse and then is there extra schooling on top of that? Talk to me about that.

[04:59] Taofiki: It depends. Not really. I think there are a lot of people I work with who've been doing Nursing Informatics for a long time. They don't have a Masters in it or anything like that. I have my Masters just because I was interested in the field. But you don't really need one. You need experience in understanding how an EHR, again, based on today's evidence and what we're doing, primarily understanding of how the nursing workflow goes, understanding of how EHR works. There are certain certificates that you can get through, like Epic or through whatever other software you're using that says, here's your certificate as a clinical nurse informaticist, or something else. Those tools take maybe a week of a class and you take the test. So it's not like a four-year or two-year program. Oh yeah, I think if you're somebody who's interested in it, you just need to be involved in your hospital's projects.

[05:54] Michelle: Okay, how much bedside experience? If I'm a nurse and I want to go into nurse informatics, what do you think is a good baseline, a good basis of how much bedside experience I need?

[06:10] Taofiki: I think there's no number. It's kind of what experience you have. And I would say, okay, if you had less than six months that most jobs won't take you, but if you've been working for a year plus maybe almost two years, then they will consider you as somebody who understands the nursing workflow. That's the most important thing about nursing informatics as it's used today is understanding nursing workflow and patient needs. And so what are the things that people are doing and how are nurses actually working? And that goes also kind of with schooling, is that, do you need a formal degree to go into nursing care management? The answer is no. You can understand the workflow in the ICU, you can understand the workflow in the ER or home health, whatever you're doing currently, and understand it intimately, and then making sure you understand a little bit of computer stuff, not a lot. You don't have to be a tech person. You don't need to know any coding skills. That's what I'm asked often. Do I need to know how to code to go into Informatics? That is not our job as nursing, to code. It is your job to understand patient care and nursing care. And so a lot of my coworkers don't have a Master's degree. They just have their Associate's or their Bachelor, and they've been doing it for 15-plus years. And so I think that the job and the degree you have now is more than enough to get most people into Informatics.

[07:37] Michelle: So workflow is really important. Okay, so I'm a nurse, and I know my workflow. Does it help if I have experience with different electronic health records like Cerner or Epic?

[07:53] Taofiki: That's fine, as long as the hospital you're working for is only Cerner. If you're working for a hospital that uses a different EHR system, that you're not knowledgeable about, then that is a problem. If you've been using Epic for ten years and you apply for nursing informatics at a hospital that's been using Epic for 15 years, then you're good to go, because they expect you to know where certain things are and then end users, aka nurses, expect you to know where things are. So if you're not familiar with Epic or familiar with Cerner and you've taken or applied for a nurse informatics job with the software you're not familiar with, that's going to be a very uphill battle in the interview, and even if in the job aspect. And so, yes, you just need to apply for some place that is in the software, you understand if you understand, both the job applications open more for you, but most people understand one.

[08:47] Michelle: What is your background? You obviously had some experience in patient care. So tell me about what your nursing background is and how you took all of that into your position now as a nurse informaticist.

[09:05] Taofiki: Yeah, as you mentioned earlier, we have a good friend named Kathleen, and so when I finished college at Fresno State, I got a job as a nurse extern, actually, before I finished college, at a cardiac step-down unit at a community hospital in that area. And so I worked there for a little bit, and after school, I was hired on as a nurse. And that was a very, very busy hospital. We had everything. The ER had a Level I trauma hospital. You learned a lot there, a lot of busy days and then after that, I went to a cardiac neurovascular unit in another part of the state of California and I worked there for a little bit. And so with about four years in my neurocardiac unit, after that, I got the opportunity to go into Informatics. And the part I want to share about that is that the Informatics position kind of didn't come from a traditional route. When COVID happened and all these patients were in their rooms alone, dying without family at their bedside, I sent a long email to the CNO of my hospital detailing what we should do to make sure these patients can see their family members, what devices we need to buy and all this and that. And so she said, oh, this is a great email, but I think I need to send you to the head of our IT department, who would be this CIO, the Chief Information Officer. And so I kind of had an informal meeting with him, told him my plan, and he said, hey, good to know, but we're already working on something and we need your help because it will be nurses who are primarily using these iPads to talk to family and to talk to patients. And so can we pull you off the floor to figure out how we can do this for the best way that works for patients and nurses? And so that was kind of my entry point into Informatics. Even though I'd been in a Master's program for about six months prior to COVID breaking out and going everywhere, I made this initiative and reached out to my CNO, who then leads me to somebody else in the C suite. And then kind of how I got my job is by being a squeaky wheel and having a plan.

[11:24] Michelle: That's epic, that is advocating for nurses and patients at the very highest level, that is thank you. So interesting. Yeah, that's well, God bless you. That's all I can say. That is just really cool. I love it.

[11:44] Taofiki: A lot of us nurses, we get frustrated with many things in the day-to-day that we're working in and what management and a lot of people might disagree with me, but I think what management wants to hear from you is, what are we going to do about it? What are your plans that are feasible? What are your plans, because from day to day they get told a lot of things are broken. The staff members that they reach out to for assistance to help with programs are people that say something's broken. And I've spent two months thinking about how to fix it. Here's the plan. That's what most people value, whether you're working or not, whether this is your best friend, whether this is your no-matter-what relationship you're meeting with somebody, people want to hear you say what's broken.  And also what are we going to do about it? That's kind of, I think, why they were willing to give me this chance, somebody without a formal, Informatics background. And I've been doing that since 2020.

[12:37] Michelle: I think you're right. I think that's what they want. And I do know that nurses in our workflow, we see things that we don't like that are not running smoothly. We always think this could be better. They need to do this, they need to take this out, they need to add this. It would make it run so much smoother. This is double charting. This is triple charting. And so we talk about it a lot and we complain about it a lot, but I think there's the fear in many nurses that, well, if I go out on a limb and I say, you guys need to fix this, that I'm going to be met with resistance, they're going to tell me, we can't afford that, or, you don't know what you're talking about. You don't have any experience in this field, and so we just shut down and we don't do it.

[13:37] Taofiki: That's a very fair assessment, there are managers who want to keep the status quo despite people being unhappy. There are C-suite staff that want to keep the status quo despite people being unhappy. And I think it's about coalition building. If you talk to every single department that you can reach, maybe everybody on night shift has the same issue that you're having that is a bigger voice than everybody on, that's a bigger voice than, I have this issue, and that's a bigger voice than my department has this issue. And it's everybody on night shift when this software blah blah blah. Or when this item, this program, this doctor, whatever it might be that you're having issues with. If you've reached out to multiple people and you guys linked arms and said, Okay, on October 10, we're all going to go to the manager's huddle. Or to one specific manager or to this person and say, Hey, all ten of us from different departments have this issue. It speaks volumes. Does it mean they're not going to shut it down? Does it mean you're going to magically get the answer you want? But it's a lot better to have a coalition behind you because then it's not a one-time incident and it's about coalition building and that sometimes helps out even if they say no, at least now you have a support group to work with in case they do say no, that you're like, man, that sucks. And now you have something to reach out to as opposed to doing it on your own.

[15:05] Michelle: Yeah, right. That's a really good point. In our unit, so in the NICU, when we were switching over from Centricity Perinatal to Cerner, it was a huge learning curve, obviously. And our management, really, I've always appreciated our NICU management, but one of the things they did was have these big Post-it notes everywhere and as people were going through the workflows, write down things that you like, write down things that you don't like. And a couple of times a week, we were meeting with the Nurse Informaticist and saying, this doesn't work. We love this. Don't take this away. And it was really effective. We felt like we were really being heard. Yeah, there's strength in numbers. And I met a Nurse Informaticist when we were switching over to Cerner, and I didn't have any idea what she did until I met her. And then we started working really closely together because Cerner didn't have a program for the Neonatal Intensive Care unit. They had an Intensive Care unit program, but they were kind of trying to build a NICU program using the ICU program. It wasn't ideal at all.

[16:41] Taofiki: Makes sense.

[16:42] Michelle: So, yeah, my position in the NICU was a developmental and lactation specialist, so it was getting even more niche. And I had to work with this person for about a good three or four months on building my program as well.

[16:58] Taofiki: What you needed to document and this and that.

[17:00] Michelle: Yes, exactly. And how do you write a program for, say you're working with me, and I'm saying, okay, I need this to be here, and I need this document here? How do you go back and make those changes?

[17:19] Taofiki: I think I'm not sure how Cerner does it, but as I mentioned earlier, the good news is that it's not the responsibility of the nurse to do the programming. My hospital that I've worked as a nursing, from an assist, we have builders for that. Builders might be former nurses, they might be former medical assistants. They might be somebody with no clinical background, but the majority of them have some clinical background. And so you would take everything, let's say if I met with you and talked about the NICU documentation workflow and the charting and all that stuff, I would take everything you've written, use a very technical term company called a build spec. And then I would take that build spec and hand it right to the builders, and then they would go, oh, okay, they want this here, they want that there. They want this here. And have you thought about this? And I was like, oh, yeah, we talked about that in the meeting. She wants that exactly where she wants it. And so that's the good thing, is that it's just you need it. You're kind of a translator between the builders and the end users. And that's kind of the fun part about it, is listening closely and asking good questions, but also knowing what limitations of the software are. A lot of times with end users, they say, oh, I want this to do this, and it's like, right now, if they can't do that right now, Cerner can't do that. It'd be great if they did, but they just don't have the capability to do that. But we can put it here. Does that work for you, oh, no, it's too many clicks. I'm not going to go there to find it. And so understanding what the limitations of the software are, but also the part that I know, especially with me having an informal, informatic background, one thing I always say is, I don't know, let me reach out to the builders and ask them if that's possible. So I try not to shut down end users and what they're asking for because I don't know everything that's possible in Epic. And so I will take it to the builders and go, yeah, that is technically possible, and we can make that happen. And so we go from there.

[19:23] Michelle: Yeah. So you're like a bridge between the nurse and the builder.

[19:27] Taofiki: Exactly. Okay. And then the strong, important bridge is key.

[19:35] Michelle: Yes, that is key. Do I need to know a lot about technology to be in this role?

[19:46] Taofiki: No, I think you need to be comfortable with basic things such as Excel spreadsheets and Word and PowerPoint to really be in this role. There are some yes. No, I would say no, you don't need to understand how to code, as I mentioned earlier, you don't need to understand how to do anything very technical, just the basic computer skills and understanding how to use those Microsoft tools or Google tools, whatever your hospital uses, and that's about it. Being able to navigate a computer will help, will definitely help. Knowing where to click and how to translate that also for users is, again, the important part. When somebody's saying, when I click this button, it doesn't work, and it's like, oh, okay, I need you to do whether you're on the phone with them or whether you're in person with them, telling them what to click. Being able to dumb down actually, I didn't like that term. Being able to translate technical speak to an end user is very key. So, again, no coding needed. No, like, you don't need to be the type of hackers you see on TVs and movies. You just need to be someone who's friendly and understands basic computer skills.

[21:04] Michelle: Okay, well, speaking of hackers working in the field that you're in, have you found that electronic health records and just hospitals in general are, like, vulnerable to cyber attacks?

[21:20] Taofiki: Oh, definitely. I was talking to somebody about that online today. Yeah. For the last 10-15 years I've been really about data analysis and data management, with some minor focuses on data security. But I think a lot of people have been told to go into computer science degrees, but not a lot of people have been told to go to cyber security degrees. And so, of course, for nurses, you would still be a nurse informaticist. This was the focus on that stuff. But I think that's kind of where we're going to be going the next 15-20 years is, okay, yes, we can compile all this data, but how do we make sure only the people who look at it could see it? And so hospitals have very, very, because you're dealing with private patient health information, you have to be very, very strict. And even from the emails that you use in your hospital because they run on a similar network that the EHRs are using, you need to be very careful what link staff are clicking on, what they're doing so somebody doesn't enter the hospital's internal network. And there are many things that what is typically called Information Security Department, every hospital has them is in charge of making sure that maybe the HR software is running on a different network than the basic computer. There's just layers that they have to make sure that even if one part of the hospital gets hacked, they don't access others. But sometimes people will access all three and I mean all layers of the hospital system. That's a big, big problem. But typically hospitals are doing their best and trying to educate staff to be very careful what they do when they're on the hospital's network.

[23:04] Michelle: Yeah, well, if changing our passwords is any indication of trying to keep everything on the up and up, then they've got that down.

[23:15] Taofiki: Yeah. I feel like that's the thing a lot of people relate to, is like, why is it why is my password getting longer and longer?

[23:22] Michelle: Yeah. And having to change it more often. It's like three months ago, I just changed it.

[23:28] Taofiki: It really depends on the hospitals. Again, whoever is the head of information security at your hospital, my hospital just recently went to a 14-digit password policy, or 15. And you do not have to change it anymore and frequently. So once you've done 14 digits, I think whatever resource they've looked at, it's very rare for somebody to accidentally guess your password at that number.

[23:54] Michelle: Right.

[23:55] Taofiki: And so we're not switching from now until forever. I'm sure there's going to be something that happens in the next couple of years that makes us switch. By supposed to switching every six to seven months, we now technically don't have to switch again because we're using such a long string of letters.

[24:13] Michelle: Sure.

[24:14] Taofiki: Can I get one little soapbox about passwords? What we should start calling them are passphrases. Because it's easier for you to remember and harder for somebody else to guess. So if there's a phrase you say to your kids, your dog, your significant other every single day, that's what your password should be. Because nobody except those in your household can know that. That's not something they can guess by looking on your social media profile. But a word. Maybe the town you grew up in, the college you went to, your friends online, and your favorite drink. All those things that are public about us can be easily guessed. But phrases that we use every day, maybe there's a certain phrase you call your dog or your significant other that nobody else would guess. That is the best thing to do is use the passphrase and it's easier for you to remember. Like, I'm going to think of an example, I can't think of a great example, so you can edit that out. But if there's a phrase you say every day, such as, like, my dog jumps on the table, 845 exclamation mark. Nobody can be able to guess that.

[25:26] Michelle: My last password before retiring was a phrase and it was actually, I think, 18 letters exactly. People would watch me putting it in, and they're like, really? I'm like, yeah, no one's going to guess it.

[25:43] Taofiki: Exactly. 18 is long, but you type it because it's words. It's like typing an S. It was easy.

[25:50] Michelle: Exactly, yeah.

[25:51] Taofiki: Good job for you.

[25:52] Michelle: Oh, yeah. So this might seem like a dumb question, but do you, as a nurse informaticist, do you guys work closely with, like, the IT department?

[26:07] Taofiki: Yeah, that's a great that's a great actually, I love that question. A lot of people don't understand the separation between IT and informatics, and sometimes I still introduce myself as it depends on who I'm talking to, so I don't have to explain what informatics is. The IT department is in charge of all the basic hardware, but the hardware that you're using, whether it be the computers you're charting on, whether it be the WiFi that your WiFi routers that are set up without sorry, whether it be the WiFi router set up throughout the hospital. And so, yeah, we currently don't work closely with IT. It depends on what's going on. It's on a week-by-week basis. If a lot of nurses are complaining that certain action is happening on a certain device in the hospital, and I might be the first one to hear about it because they route things sometimes to the nurse informaticist first. Now, though, this seems to be an IT problem where whether it be that computer has a broken screen or a broken mouse or broken microphone, whatever it might be, then you'll end up routing it to IT. But yeah, it depends on the project. My hospital is working on different projects to give nurses certain tools and devices that are cell phones and stuff like that. So you do have to work with IT on how to get new cell phones, provision for nurses, and stuff like that. It really depends on but I would say most of my week, no, I don't talk to IT, but there are certain projects and incidents that require me to talk to IT.

[27:40] Michelle: Do you like when you have to talk to them, or do you like the interaction? Do you like talking about all the technical stuff and the hardware and the software? Do you have knowledge about that?

[27:55] Taofiki: I don't have a lot of knowledge about computer stuff. I'm somebody who has a lot of like, I know a lot about cell phones and wearables, but not like servers and mesh networks and all the other stuff that you need to make a hospital run. So I don't mind talking to them. That's not the stuff that super really excites me. I can talk the language if I need to, but it doesn't excite me. Nursing workflow excites me, and hospital care excites me, but it really depends on their families. But for me personally, it doesn't really do anything for me. Unless we're talking about, again, futuristic products like giving nurses the ability to turn off a call. Like when they walk into a room. That's really cool. And some hospitals have that because it depends on the device that nurses have been given. So that stuff requires help and that stuff requires nursing informaticist help. So yeah, on the day then not really.

[28:57] Michelle: Okay. I worked pretty closely with an IT guy that, sounds so like unprofessional, a gentleman from IT. Yeah, it was fun learning about all that because I was always the one on the unit because I had a little bit more free time than the nurse at the bedside. And so what would happen is I would go to relieve them for a break and I would go to chart something and the computer would not be working. And I'd say, hey, this computer is not working. Yeah, I know. Did you call IT? No, because I always have to wait on the phone. OK, so then I would call it and go through the whole thing that, you know, they'd say okay, let's reboot it, let's do this, let's do that. And the big thing that I learned from this IT gentleman was about thick and thin clients because he would ask me is it a thick client? And I'm like dude, I'm a nurse. I don't know.

[30:06] Taofiki: What does that mean?

[30:11] Michelle: He would tell me the difference and then I felt like, oh, I'm so knowledgeable. I could tell all these nurses, you know when they call me with this computer is not working, I'd say is it a thick or a thin client? And they just thought I was so smart.

[30:29] Taofiki: Those details do help out when you're the go-to person on the floor that people like because that's where I was before I left my unit. I was the person they would come find on night shift. Something broke with their computer. So knowing all these intricate details and asking extra questions when you're on the phone with help-desk helps you out so you don't have to call every time. You can seem kind of like a superhero and you're like yeah, just do XYZ. And you're like how do you know that? You're like, I don't know, I just know it.

[30:57] Michelle: I used to just be amazed at things that I feel are so basic. Like saving a document to your desktop or opening up your  M-drive or something like that. And the nurses would say how do I save this? Because they'd be working on a. Thin client. How do I save this to this computer? And I'm like, we got to save it on your M-drive. Well, how do I access that? And then we go through that whole stuff. But just like, I would get questions like, how do you copy and paste? And I'm like, really? Have you never used a computer before?

[31:36] Taofiki: Yes, sometimes. Sometimes. It happens when I know sometimes. But we're in that weird transition period. Even though technically all hospitals had to have computer systems by 2015, I think was the law. But if you think about it, a lot of nurses, especially those who have been doing it a longer time, a lot of people haven't had 20-plus years of EHR experience and computer-only documenting experience. Let's rephrase that. They've had a mix of both for ten years, 15 years, and now in the last five, six years, it's been computer only. It's like, oh, they only use your cell phone. A lot of people don't use their primary computers anymore.

[32:16] Michelle: So true.

[32:16] Taofiki: They use their cell phone. You just hold down if you want to copy something, you hold a paste. And a lot of people aren't sitting in front of a personal computer anymore unless they're in school or something. But a lot of us are not sitting in front of a computer. And I, too, get dumbfounded by that. And I'm like, oh, don't you? And I was like, oh, no, you don't use a computer at home. You use your cell phone or your iPad.

[32:42] Michelle: Yeah. Are there any emergencies in your role? What would you get really fired up about? Like, what's an emergency for a nurse? Informaticist.

[33:00] Taofiki: There isn't really. There's a couple of times that something is down, whether it be software that's down, and that's really out of our hands. If a server is down, it's up to those who work in the server room and those in the It department to get that up. We're kind of sitting ducks. All we can do is communicate with staff that this is not possible. I'm pretty sure I received a message some other time in the past that this isn't working. The messaging to the outside pharmacies isn't working. It's like, oh, for discharges, that's a problem right now. We can't message outside pharmacies. But I, as a Nurse Informaticist, have nothing I can do about it except for communicating with staff that they're working on it and that we should go to downtime procedures. There's really no emergency. The good thing for a lot of people who are tired of working at the bedside, there's a whole different stress level that happens when you're in informatics. A lot of informatics, and I say this with love who have never worked bedside, they'll freak out about something that is down or something that's not working. It's like, this isn't a code. Nobody's dying. Like, I'm not going to freak out about it. So my threshold for chaos is different than theirs. And so a lot of nurses are massive. I think they don't freak out either, but I understand the thing is urgent, but it's not emergent. Right. There's not much to freak out about. That's the good thing. And my last analogy about nursing informatics versus nursing at the bedside is that nursing informatics is kind of like a slow jog you can do, anybody can do it. No matter what your fitness level is. Most people can do a slow jog for a while. Now imagine it's been ten days, 30 days, 100 days of doing a slow jog. You're going to get tired when working at the bedside is a sprint. Every single day you sprint and then you stop and go home and de-stress when you come back the next day or come back in a week to do it, to do that sprint again. So it's like a 100-yard dash versus a cross-country run. And they're both grueling. One is immediately grueling and hurts your body, whereas the other one is aftermath 20s when it begins to hurt your body. So nursing emergency is not a stressful job but is a cause you're never really off. It's a salary job. If I get a call, if I was on call this weekend, for some reason I could work on the weekends even though it's my day off. Right. Whereas nursing, if you clocked out, there's no reason for anybody to be calling you. And that's the difference between nursing classes one feels like a sprint and the other one feels like a jog forever until you retire.


[35:55] Michelle: That's a great analogy, a very easily understood analogy. So talking about hours, what hours do you work? Do you have to take call?

[36:07] Taofiki: I currently don't have to take call, but my hours are 8:30 or nine in the morning till 5:00-6 o'clock. It depends on what's going on. Rarely am I working past 6:30, but there have been days that it happens. If there's something that needs to go live that week, that day that needs a lot of attention, but typically it's your eight to six, eight to five job. But there's a lot of flexibility, at least at my facility. Some of us start, some people work all day at home and then maybe other days of the week they come to the office. I like to do more of a,  I'll start my day at home, and then maybe around eleven I'll go to the office. Continuing like at work, just kind of have a different setting. I don't live too far from the office so I don't mind doing that. Or maybe I'll start my day in the office and then I'll go finish my work at home. So it really depends on what's going on.

[37:06] Michelle: Sounds very flexible.

[37:08] Taofiki: Yeah, at my facility it's very flexible in some places have full remote work where you can work at a place like UCSF and work from anywhere in the country or work from anywhere in the state. Some places still require you to be 100% in person. And so we're kind of in this wild, wild west of hybrid land where even people like Apple or companies like Apple are now asking their workers to come back to the office and stuff like that. So some places are going to maintain it for the long haul. Some places are going to sunset those things soon.

[37:46] Michelle: What settings can a nurse informaticist work in? Like you work in a hospital. Where else can they be employed?

[37:55] Taofiki: Right now, the majority of his hospital work, and as I mentioned at the beginning of this interview, is that I think that's great. I think that's very limited, though. There have been a couple of job openings from the likes of Apple, from the likes of Amazon, from the likes of Microsoft. There are many of those jobs that are popping up. They go quickly and they're not as abundant as hospital jobs. But as I mentioned before, because we're having this recession, things are probably going to slow down a little bit. But there is this big push from these major tech companies to do something in healthcare because it's kind of the forever business, right? Unfortunately, enough people eventually will buy enough cell phones that even Apple cell phone sales are decreasing. Not a lot of people bought their new cellphone, the 14 or whatever it's called. There are always going to be people who need health care and understanding how they can squeeze themselves in the pipeline of healthcare is their next kind of big business endeavor. And so you can work it, you can work in many different places. But right now the majority of nursing practices are working in a hospital and a few are working outside the hospital or startup companies for very established companies amazon, the Apples, the Googles of the world, and there are a couple in between. I'm sure there's somebody who works for dialysis companies, right? Because dialysis is staffed to chart and document, somebody has to figure out how to make sure that charting and documentation are working appropriately.

[39:30] Michelle: So, being in your role, are you in contact with patients in any way? Do you talk to them on a daily basis? Do you query them about their care or anything like that?

[39:44] Taofiki: No, I don't. Nursing informatics mainly focuses on nurse workflow and not patient focus. So I haven't had to talk to a patient in a while. Maybe when we were rolling out iPads, when there were no visitors out loud to the hospital. There have been a couple of cases where I've had to talk to patients and their family members that were having difficulty communicating with people outside the hospital. But 99.9% of the time I'm only talking to nurses and or other people in the informatics pipeline.

[40:19] Michelle: Do you miss it, talking to patients?

[40:23] Taofiki: No, not really. Because I think the goal, at least for me, the great part about nursing was problem-solving. I'm a problem solver at heart, when you come in sick, and that we've helped figure that out. We've solved that problem. And so I'm still getting that fix, for lack of better terms, by helping nurses figure out what they need. They call me and say something's not working. I can't figure this out. Okay, let me figure it out myself, or find someone who can help me. And so I don't miss if I wasn't helping people, then I would say I miss it, but I'm helping people, and I just happen to be helping the helpers for lack of better care.

[40:59] Michelle: Absolutely. The end result is patient care. And you're helping the nurses do a more efficient job.

[41:10] Taofiki: Yeah. Have less headaches charting.

[41:13] Michelle: Yes, gosh. Everybody could welcome that. What opportunities are there for growth in your field? Like, what's the top of the field? Talk about that.

[41:25] Taofiki: Great question. The kind of latter is your nurse informatics. And then maybe you become a manager for nursing informatics, and then maybe you do that for a while, maybe become a director, and then it depends on the hospital. Not a lot of hospitals have this. Then maybe you become a chief nursing information officer. CNIO. Not many places have a CNIO. But that will be the job of a CNIO to ensure that every single data point that a nurse does involve technology. That involves data. That involves workflows. That they are on the high level. Making sure that that's being thought about when hospitals are doing new projects. When hospitals are doing new expansions. Or deciding if they want to roll out new software or something like that or fix the current one. That would be I would say that is the top of the ladder for nursing informatics. It's not for me. That's not what I want to do with my career. But I think that's kind of where I would hope more hospitals are hiring those people to look out for nurses. Because there are lots of CIOs. There are lots and lots of CIOs. I think almost every hospital has a chief information officer, but mainly a small percentage of chief nursing information officers.

[42:54] Michelle: Well, I saw that the ANCC has a certification for nurse informatics. It's the RN-BC board certified. Do you have that certification or are there plans for you to get it or do you need it?

[43:08] Taofiki: No, you don't need it. Again, there are certificates through Epic that are probably beneficial, but if you're somebody who doesn't have a lot of experience in nursing masters and you just can't seem to find yourself a job, I would say get that certificate, get any other certificates you can. The other major part is that, again, helps be a squeaky wheel. What projects are being implemented that require a nursing workflow? How can you be a subject matter expert for the nursing practices at your hospital? So do a couple of projects, put those on your resume, and then get these certificates, and somebody will find that. But no, you don't need it. But it's beneficial for somebody who does not have the experience, especially when they're leaving the bedside and maybe they have the degree and they just can't seem to find a job. I would say that would be a great certificate for them. Since I have a nontraditional entry besides my Master's degree, my entry into Nurse Informatics is from a nontraditional route. I don't really feel the need for it at this moment. And there are other things I'm working on. I mean, another nurse in a small business, and that is my end goal for my career. And so nursing practice is fun for now, and I'm a technologist at heart, so it is what I like, but it's not my end goal.

[44:31] Michelle: Well, I do want to talk about your entrepreneurship in just a minute, but what advice do you have for the bedside nurse? This looks interesting. I want to get into it. What's the first thing that I need to do to become a nurse informaticist?

[44:51] Taofiki: Reach out to be a super user at your hospital. That is the first and easiest thing you can do because a lot of people don't want to do it. So I'm sure there are a lot of hospitals who are begging and clamoring for people to be part of their super-user program, and the people who join meetings on a quarterly or monthly basis, I'm not sure. So they would love you for that. And then through there is where other avenues open, and that's where you can be on projects, you can be this, you can be that. And so I would say the first and easiest thing to do is ask your manager, hey, do we have a super-user program? And I would love to be a part of it because I'm considering getting my Masters in Informatics, and that would help me figure it out I'm considering getting the certificate through the ANCC. And this will help me kind of see what those people do because the person running the super user program or helping run it is most likely the nursing practices themselves.

[45:52] Michelle: Yeah. So reach out and be the squeaky wheel and show interest.

[45:56] Taofiki: Exactly.

[45:57] Michelle: Yeah. And I read that nursing informatics is in the top 15 nursing specialties for pay. So does it pay well? Is it a lucrative job?

[46:11] Taofiki: Okay, it depends on the hierarchy. The bedside is the best, right? Because you have your defense, you have this, you have that, you have your overtime when your salary, whether you work 20 hours, whether you work 60 hours, the pay is the same, at least for my hospital. And there are no unions or nursing informaticists. And so I came from a union position, and I left that, and I came from a night shift position, and I left that. So it was actually a pay cut for me going into nursing informatics. And that was okay. Yeah, that was okay for me to have that pay cut, I would say getting a guaranteed 40 hours is nice, right? Yeah. And so whether you work less or you work more, that's the thing. Both of you are working more. So there are rarely any slow weeks in the hospital. Right. Something is always breaking. But I don't know. I've never compared it lucratively, but what I know is, from my personal experience and believing the beds, that I've made less money because there is no picking up extra. There is no overtime, there's no night shift differential. You rarely have to go in at night. There is maybe once a year something happens that you have to go in at night. That's very, very rare. And there is no extra pay. There's just a pat on the back and maybe a gift card from your manager or maybe nothing. Just a pat on the back, if that.

[47:35] Michelle: Well, I mean, your answer just proves that some things are more important than money and definitely your own time and not working overtime and flexibility with your schedule, with your family, all those things definitely weigh into it. I do want to talk about your entrepreneurship because it's, you know, amazing. And so you are the co-inventor of Safe Seizure pads. And I have to tell you that I went on the website and checked them out, and they look amazing.

[48:15] Taofiki: Thank you.

[48:15] Michelle: And I wish we would have had I wish we would have had those Safe Seizure crib pads when I was a pediatric nurse, that those would have been really valuable to us. So, like, bravo on that.

[48:28] Taofiki: Thank you. About the Crib pad, Joey and I are adult nurses, and so we had no idea about that world until we were in servicing a hospital. And we went to the pediatric department to inservice them on our standard model, which fits, you know, Med-Surg beds, ICU beds, etc. But and they were like, are you guys making some for the cribs? And we were like, what are you talking about? They're like, yeah, cribs need pads too. And we're like, they do, and they get the whole rundown. And we're just not aware of that world or the lack of pads and the awful pads. It's similar to it's easy to understand the adults' aspect, but it was like a different language. It didn't click in my head that babies and cribs would need those.

[49:16] Michelle: I've seen a lot of kids having seizures, and it's really scary as a nurse and of course, as a parent too, but I think Peds is kind of maybe a little bit forgotten in those types of areas. So I was just so happy to see that you guys provided something for that population. But you and your co-founder, you guys won the 2020 American Nurses Association Innovation Award. That's fantastic. Congratulations.

[49:54] Taofiki: Thank you. Yeah, that was an interesting award. We actually applied in 2019, and we lost, rightfully so. Our good buddies, Paul Coin and Mike Wang, with some people at MIT, applied for they created another product that's just phenomenal. It's this device that goes on the wall, but they'd won that year. So we were kind of unsure if we should apply in 2020, and we decided to take a once over in our application, change a couple of things, and then we won. So exciting.

[50:29] Michelle: Yeah. I have the utmost respect for nurses, first of all, but nurse inventors, I just think they're amazing people because they're thinking about the greater good of humanity, really, and they're thinking about their fellow nurses. And like you said, making life easier for them, and that's a great goal. I interviewed Joan Ortiz in episode five, and she's the Vice President of Limerick Inc. she and her mom invented she's a nurse, and her mom's a Registered Dietitian, and they invented a breast pump and started a company, and they've been very successful. They have a very superior product. So I just have so much respect for you and what you've done. I think it's really great.

[51:25] Taofiki: Yeah. A breast pump is phenomenal. That's more intricate than what I created. So good on you, Joan.

[51:32] Michelle: Yeah, she's awesome. Well, oh, my gosh, I have learned so much, and I probably have 10,000 questions, like, in the back of my mind, and probably when this interview is over, I'm going to go, oh, why didn't you ask that? Why didn't you ask that? You're working in such an interesting field, and you're just doing so much good. I don't know if you're acutely aware of how much you're doing, but for the nurses and one who has worked with someone in your field, your work is so important to us in making everything go more smoothly and just elevating patient care, really. So thank you.

[52:19] Taofiki: Thank you. I really hope that all the nurse informaticists out there are trying to not be roadblocks but to be assistants in helping people do their job.

[52:34] Michelle: I love your philosophy, and once again, I'm very thankful for Kathleen introducing us to each other, so I'm definitely the winner on that side.

[52:47] Taofiki: Kathleen's amazing. It was great.

[52:50] Michelle: Oh, my gosh. She's my NICU expert. She was wonderful. So one of the things I do at the end is the five-minute snippet, and I asked you a few of your topics that interest you. So are you ready for the five-minute snippet?

[53:09] Taofiki: Yeah, sure. I don't remember what I wrote, but I'll do my best.

[53:14] Michelle: It's all stuff that you know the answers to.

[53:17] Taofiki: I promise. That's good. Okay.

[53:20] Michelle: It's just a chance for our audience to kind of get to know the off-duty side of Taofiki, so it's kind of fun. So I'm going to start my timer, and then I'll just start asking you questions. Okay. Fancy restaurant or local dive?

[53:44] Taofiki: Fancy restaurant.

[53:46] Michelle: Really? Okay. I totally had predicted you were going to say local dive. I don't know why.

[53:52] Taofiki: Well, I don't know. That was a rough one. But if I think about my favorite food experiences, they've been a very fancy restaurant. So that was why I want that. Good answer.

[54:03] Michelle: Is there one particular locally that you like?

[54:06] Taofiki: Oh, this is bad. I know. I don't remember the name right now, but there's a restaurant in San Francisco that a friend of mine bartends at, and it's a place where when famous people are in town, they go there. And the only reason I was able to get there is because my friend bartends there, but having yeah, we spent the whole night there and it was phenomenal. And the wait staff was phenomenal. The drinks were phenomenal. I don't like they have a bottle from 18 something. They have bottles, and drinks from the 1800s. I did not order it because it is thousands of dollars, but it's like on the list bucket list of mine to go there and have a sip of that. But yeah, that can get those types of experiences not at the local dive bar, but at, like, really fancy restaurants. And they stick with you, at least with me.

[54:59] Michelle: That's true. Yes. Did you ever buy a gadget from an infomercial?

[55:08] Taofiki: No, not off the Internet. Well, that's kind of hard these days. Everything feels like an infomercial. Social media, I would say the good answers from the television called a number. No, I have not.

[55:22] Michelle: Overall, do computers save time or waste time?

[55:27] Taofiki: They waste time, unfortunately. Waste time. I would say tools are as good as what you use them, and we use them for wasting time.

[55:40] Michelle: If you could be trained by one thing, or if you could be trained in one thing by the top professionals, what would you choose?

[55:51] Taofiki: Oh, that's really hard. Shoot.

[55:53] Michelle: I know.

[55:55] Taofiki: I would say, oh, dang, this is okay, one thing. It would be. I'm going back and forth between the ability to build anything, like people who are really good at building stuff, and also playing the guitar. I can't decide because they're two opposite things, but I love them both. I will go with building gadgets. There are some people who are able to just put things together in their house and just build it immediately. I'll go with that. Okay.

[56:30] Michelle: What do you think is the most undervalued profession today?

[56:34] Taofiki: Most undervalued profession today? Almost undervalued profession? I would say teaching, teachers are most undervalued profession today because we've all had to have a teacher. Not everybody's had to have a nurse. Not everybody's had to have a doctor. Not everybody's had to have a landscaper or anything, but we've all had to have teachers. And yet their pay is abysmal. Yet their benefits are dismal and all that stuff.

[57:10] Michelle: I agree. Yeah. Do you have a most-priced kitchen gadget?

[57:17] Taofiki: Most priced kitchen gadget would be like gadgets. I do like gadgets, but I have oh, God, this is the issue, these questions because your mind goes blank. I would say my most prized kitchen gadget, I'll go with one that I'm staring at and it's popping up. If you gave me more time. But I'm looking at it right now and I have this Ninja coffee maker that does hot water and it does coffee, it does iced drinks, it does specialty drinks, it does, you can do a coffee ground coffee, you can do coffee pods. It is kind of almost in every liquid gadget thing we think of. Like we got rid of our kettle because of this because this does instant hot water from it. So why do I need it? And it also has a milk frother on the side of it.

[58:13] Michelle: Oh, that's sweet.

[58:16] Taofiki: It's kind of like we live like most people for a long time. And this kind of does everything. And I don't need a kettle, I don't need a milk frother device. I don't need multiple things. I just have this. And it does almost everything.

[58:32] Michelle: That is cool. Well, I can tell you like your coffee.

[58:37] Taofiki: I'm not the coffee drinker in my house. I drink coffee maybe once a week. My wife is. But I like things that are versatile and it allowed me to clear up a bunch of other gadgets on my counter.

[58:46] Michelle: Yes, multipurpose and save some space in your kitchen for other great gadgets. Right.

[58:54] Taofiki: That's cool.

[58:56] Michelle: Well, this has been so informative. I truly can hear your joy for this position and your knowledge of it. And again, I just thank you for doing what you do to help nurses, help patients.

[59:15] Taofiki: Thank you for putting this on.

[59:17] Michelle: Yeah, and thanks for coming on and just talking about all things nurse informatics.

[59:25] Taofiki: You're welcome.

[59:26] Michelle: You have a great rest of your Sunday.

[59:28] Taofiki: You too.

[59:29] Michelle: Alright, take care.