Don't let computers scare you.

If we as long-term care nurses had heard anyone talk about computers in the workplace 10 years ago, we would never have believed how much they'd become a part of our daily work lives in 1996. Today, whether it is our care plans that "read out" as part of our CNAs' duty assignment sheets or our MDS work reflecting back to our care plans, computer work is here to stay. Don't fight it - join it!

Does the fact that your nursing home must soon be "on-line" with its state survey teams, if it isn't already, frighten you and/or your administrator? It shouldn't. Consider what must be done to keep your facility in compliance with current law and use it to your advantage. We all fought OBRA at the onset, but now that we've lived through the beginning nightmares, the end results are for the most part very positive.

And here is one way to take a positive stance toward computerized MDS work: Look at it as a major step toward restorative nursing. Once a "restorative mentality" is adopted, your staff will never want to return to "the good old days." As residents are brought to their highest level of functioning and their feelings of self worth and dignity improve and grow, you and your staff will be much happier.

With the introduction of the MDS into nursing homes, we have no other choice than to think "restorative" because the MDS is a type of report card for the resident - and therefore for the facility - on how well we are doing to bring the resident to their highest level of functioning and keep them there. The MDS, then, is a very positive tool, and we should be glad that computers will help make it readily accessible to state surveyors to document our success.

Use of computers may help with another facet of this: getting all departments and all employees involved in resident care. Nursing, therapy and activities staff are not the only ones responsible - everyone who works in a nursing facility can certainly be a part of helping residents. Unless a resident is on fluid restriction, everyone who comes in contact with that person should offer him or her something to drink. A Texas-based therapist I met recently pointed out to me that a resident who is not totally oriented may not think of reaching out to get a drink of water off the bedside table, even if it is in plain view. She also related to me that facility staff were encouraged to have any employee or appropriately-trained volunteer who walks by a seated resident to, in some way, encourage the resident to change his or her position. Shake the resident's hand or give a hug, using this opportunity to help the resident shift his or her weight, even slightly. If possible, have the resident stand, which allows the long bones in the legs to bear weight and thus maintain calcium.

Where do computers come in? Getting staff attuned to directly writing in or reading from a computerized care plan helps them develop a greater sense of individual responsibility for resident care. The best systems encourage the sharing of data. And sharing data helps build a sharing attitude.

So don't be afraid of those computer programs - use them to help devise your residents' plans of care. And make sure the entire staff knows what the problems, goals and methods are on each resident's care plan; a good computer program will lay all this out clearly.

The computer shouldn't be scary. It's a tool, after all, and it can work for you.

Karen L. Bonn, RN, ROF, a former Director of Nursing, is founder and president of Restorative Medical, Inc., Brandenburg, KY.