The role of physical design and informal communication

o Expert – interprets labs; consults physician when labs are
abnormal; recognizes patterns in labs that signify changes in patient
condition; correlates patient’s physical symptoms to the labs that
correspond to those symptoms
6. Computer: Policy and Procedure
o Novice – accesses Crouse’s internal search engine to look up
policies and procedures (dictates what a nurse can and can’t do and
should and shouldn’t do)
o Expert – questions policies and procedures when it might not be
appropriate for a given situation (based on their clinical expertise)
and brings it to the attention of the appropriate staff member;
violates policies if based on a matter of patient safety
7. Discharge
o Novice – accomplishes the task; reviews discharge docs; removes
IV
o Expert – assesses patient safety; verifies that patient understands
medications, instructions, and makes sure they’re going home to an
appropriate environment; verifies that patient is going home with
proper supplies (cane, nebulizer, etc); prepares patient for discharge
from the time of admission; works with family, not just patient, during
the process
8. Admission
o Novice – gets patient into the bed, starts physician’s orders, checks
vitals
o Expert – makes sure medications are consistent with what they’re
taking at home; understands diagnosis and sets room up in advance
(proper equipment); examines psychosocial issues and works with
family (may have to stop normal work tasks to do this); charts out
course of hospitalization for the patient (tests, duration of stay, when
physician will see patient)
9. Independence
o Novice – needs someone to tell them what to do at all times
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