Nursing Informatics Entry-to-Practice

By: Matthew Byrne, PhD, RN, CNE, St. Catherine University

My first exposure to a nurse informaticist was through a mentoring experience I had as a nursing student. My mentor was a talented clinical report writer working in the hospital’s quality assurance department. It is clear in hindsight that she was doing high-level and high-value nursing informatics work despite her title and lack of formal informatics education. As I have taught and been taught about nursing informatics in multiple settings and contexts, I have always been interested in better understanding the many pathways to nursing informatics practice.

Nursing as a profession began as an on-the-job apprenticeship. It has blossomed over time into a robust, formalized discipline with a unique set of competencies, specialty roles, theories, and an evidence-based scope of practice. Nursing informatics as a specialty was defined more formally starting in the 1980s (Staggers & Thompson, 2002). In comparison to specialties like nursing midwifery, which traces its roots to the 1930s, nursing informatics can still be seen as maturing. Validating its youth are self-reports by nurse informaticists that continue to show both formal preparation and on-the-job skill-building as entry-to-practice options (Anderson et al., 2020).

Ever since the integration of technology into health care there have been nurses leading technology initiatives and shaping health care innovations. Many of these nurses, much like my mentor, were doing “informatics” work before it was a more recognized specialty. These individuals grew within their roles as professional pioneers and invented the specialty along the way. Without these foremothers of nursing informatics, the specialty would not exist.

Given its progressive maturity, how does formalized preparation in a graduate or certificate program differ from an on-the-job pathway to a career in nursing informatics? My personal pathway was a balanced one. I learned on the job, guided by mentors who, by my estimation, were incredibly skilled and influential. The mistakes I made, as well as the successes of hands-on learning, were also powerful teachers. Exposure to technology, workflows, and informatics principles in vivo created a rich learning environment. The price was certainly right, as were the opportunities for mentorship and internal advancement options. My challenge came in realizing that I was essentially becoming specialized in a specific set of platforms, applications, and workflows that, in some cases, had the potential to limit my learning or advancement.

A formal academic pathway, with or without certification, can enhance on-the-job experience or set a strong foundation for capitalizing on an entry-level position or role opportunities. Academic work can create a broad set of transferrable skill and knowledge sets. Learning broad informatics principles instead of just one vendor’s product or one agency’s processes can prepare a nurse informaticist for many practice environments and roles. Salary comparisons from surveys of nursing informaticists are another argument for education as a pathway to practice. They show that higher levels of formal education equate to greater pay (Anderson et al., 2020). Formal education comes at a cost that, ideally, will be countered by a wide range of role options, assured mentoring, job placement support, and potentially greater pay.

The demand for nurses to shape technology and technology-dependent processes will continue to promote diverse entries to informatic practice. Whatever their pathway to practice, nurse informaticists need to ensure that practice environments and research continue to inform each other bidirectionally. Technology changes quickly. Some of that change comes from educational institutions that push the boundaries of innovation, and some comes from practice environments that refine practical applications and processes. All nurse informaticists, regardless of their preparation for practice, must keep informed of these changes so as to drive the best uses of information and technology in health care.


Anderson, C., Sensmeier, J., & Kwiatkoski, T. (2020). Results of the 2020 HIMSS Nursing Informatics Workforce Survey-Growth in Education and Leadership. CIN: Computers Informatics Nursing, 38(9), 431-432. doi: 10.1097/CIN.0000000000000679. PMID: 32925248

Staggers, N., & Thompson, C. B. (2002). The evolution of definitions for nursing informatics: A critical analysis and revised definition. Journal of the American Medical Informatics Association: JAMIA, 9(3), 255–261.

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