In the event of a hospital cyber attack, one of the best strategies is establishing an interim communication system. While networks are down, you and your colleagues will likely need to coordinate the use of cell phones, landlines, or hand-written documentation to maintain care and communicate clearly. Additionally, the following recommendations can help you stay organized—and calm—under pressure, while the appointed response team deals with the effects of the attack.
#1 Maintain Patient Information Sheets (“Nurse Brain”)
One of the easiest ways to curb potential damages during a cyber attack is to act preemptively, analog-style: Keep a separate, hand-written sheet of paper for each patient containing vital information such as:- Patient identifiers (name, date of birth, medical record number)
- Allergies
- DPOA name
- Contact information
- Code status
- Important medications
- Most recent vitals
- Relevant lab work
- Primary care provider
- Phone number and family contact information
- Plan of care
- Nursing notes
#2 Team Up with Your Coworkers
Not everyone is familiar with paper charting, especially younger colleagues who may have grown up in the digital age. As best you can, offer assistance and gentle reminders as necessary to maintain a supportive team environment during the attack. For example, newer resident doctors have likely never had to write orders by hand. They may need reminders on these key elements required for a prescription medication order:- Date
- Patient’s name, medical record number, and date of birth
- Clinician name, address, DEA number
- Name of medication
- Strength, form, and dosage of medication
- Instructions for use (including holding parameters if applicable)
- The prescribing physician’s signature
#3 Provide Extra Care and Reassurance to Patients
During times of disruption, patients and their families will require (and likely ask for) additional attention and reassurance. Whenever possible, try to avoid in-depth conversations about the cyber-attack itself. It’s also best to remind them that they’re still a priority despite the challenging circumstances.#4 Be Sure to Document the Crisis Situation
In the event of an attack, it’s important to note the circumstances to give context to any patient charts and notes you take. So, try to get in the habit of noting that the patient chart was done in a crisis situation of a cyber-attack. Providing context for your documentation may be valuable if:- Future legal proceedings occur as a result of the cyber attack
- Any errors or discrepancies crop up in ongoing patient data
#5 Focus on Basics and Prioritize Care
During stressful situations, it’s a good idea to rely on the most foundational nursing principles. When in doubt, remember the ABCs:- Airway
- Breathing
- Circulation
- Situation
- Background
- Assessment
- Recommendation
#6 Take Advantage of Downtime
No matter how heightened things can feel in a crisis, you’re likely to find yourself in a “wait state” at some point during the attack. During this time, you can:- Familiarize yourself with hospital policy – Your hospital likely has downtime procedures, so make sure you’re familiar with them. It’s also important to know where to access printed patient information in the event of system outages. Do your best to be patient—there are bound to be a plethora of moving parts as leadership works through the process of retrieving and organizing data manually.
- Connect with patients – Use downtime as an opportunity to sit with patients and connect on a deeper level. Though much of modern care work depends on computers, devices can often distract nurses and other staff from providing sincere bedside manner and individualized care. In other words, one silver lining of an attack might be restoring the human-to-human bonds care work is meant to enhance—even during the most challenging of situations.
- Exercise gratitude and remember your purpose – Gratitude can be one of the most reliable antidotes, even in the darkest moments. Try to focus on your overarching mission as an RN: to provide exceptional, compassionate care to people in need. Often, you can extend this commitment even beyond your circle of patients, strengthening relationships with colleagues as well.
