More paper work!!!

massEDgirl · Mar 20, 2002

peace , joy, and love to you to micro.

Admiting orders...yes...which we do get and have no choice but to be given.

But complete pt history before going up stairs?? When??? Oh yea..I might have time inbetween those three traumas.

I happen to like...no I happen to love ED work.....more hands on with the patients. Yea we have our own documentation....but If I wanted to be buckled down with extra paper work I would of stayed floor nursing.

Just like my first post...none of this is meant to be attacking...just the feelings i have coming from my heart on how I feel we are treated by the rest.

micro, RN · Mar 20, 2002

massEDgirl......................

knew my take was right on..............................................

keep on nursing and I would want yours to be first to be seen by me if i was the unfortunate victim to trauma.............cause you know your stuff...................and practice....................it...............

massEDgirl.................

love back at you...............

thx micro

lever5 · Mar 20, 2002

hey guys,

Solve the problem, the check lists and history can be filled out by family members in 90% of the cases. One hospital I worked in constructed a document that was user friendly for family members to fill out. We usually ask them the questions anyway. Why not make this suggestion to the higher ups. And while you are at that; Put a sign in the ER advising all patients that a list of home meds is needed when a patient goes to the ER. Why can't we have that sign?

micro, RN · Mar 20, 2002

lever 5,.........have learned that secret, but thanks for the sharing here..............

truly the admit hx doesn't take that long...........

thx, micro

**canoehead, BSN, RN** · Mar 20, 2002

Where I work a lot of the admission paperwork is done for JCAHO, and the state and no one ever looks at it after that. So the patient may actually get better care if the nurses DON'T waste time on useless forms.

If you happen to need the information and ask it it would make sense to add it so someone else doesn't need to ask again, but I think that the ER is a fast track area, "treat em and street em"

If admin wants them to become yet another regular unit, to hold patients after they need to stay then they need to actually OPEN a regular unit. Whether the ER is busy or not the favor of holding a floor patient is just a favor, not an obligation in my opinion. And to ask them to do the paperwork on top of that? Please.

The ER then gets all the retention problems, and QI work, and keeping up on floor protocols IN ADDITION to all the ER stuff, they've doubled their workload. At some point the ER needs to insist that once patients are spilling out into the halls that the floors have to take the pts, even if they take them into the halls. and that once the ER has to go on diversion that the floors need to help them clear out all the admits waiting so that they can open again.

Asking the ER to do floor paperwork (I can't believe it!) I think someone has to just put their foot down. If you are nice enough to hold pts, no one should be whining about paperwork if the pts are safe and cared for. The folks upstairs have to take some of the load too, even if they are overworked- and we know that everyone is. If they want the admission done within 24h then they are welcome to take the pt upstairs and do it themselves, but the ER is in charge of what the ER does.

And for the record I am not and have never been an ER nurse.

massEDgirl · Mar 20, 2002

"Signs..Signs..Everywhere Signs..(isn't there a song like this?)

I think thats a great idea lever5...I am going to suggets just that at our process imporvement meeting next Monday. The only thing though is a lot of people tend to forget to bring the right info during an emergency situation....but even if half the patients bring a med list thats better than none at all...right??

micro, RN · Mar 20, 2002

massEDgirl

good to see you..........

just old micro piping back in.........

thx for letting my old replies slide off back.........

now on lighter note.............

what good does a admit hx do when all they know is well I take a little yellolw pill in the morning........and you ask do you know it's name.........they say no.....

and you ask did you have it this morning.........no maybe a week ago.............(and you are thinking it is probably lanoxim)................

when you run through the list of med conditions and they say...........no i have none of these.............and it is a 'bit' apparent that it is not the first time some of the symptoms you are seeing are there.........

God, I hate paperwork.......

i just want a checklist at end of the shift........pt. breathing in and out when i left answer yes or no

eldernurse · Mar 20, 2002

I like the check-list idea. People who bring so many belonging to the hospital that they can't keep track of them don't deserve to have them. (that includes teeth and glasses)

massEDgirl · Mar 20, 2002

Ha Ha..Yea those teeth and glasses are always getting in the way.

When a patient is admitted there are (in my teaching hosp anyway) Admitting Residents who do a Complete History and Physical and check out.....what meds patients is on. They even go as far as to call their Drs office or the pharmacy they use to get the correct list with times and dosages. This all helps THEM write their orders I am curious who actually looks at all that admitting paper work that you guys (nurses) do on the floor anyway. (maybe a lawyer will need to look at it at some point).

Like I said earlier ..I have no problem looking at the admitting orders and doing what is needed while the patient is holding with us...I will write what ever I do on my ED nurses notes......as far as I am concermed that's enough for me.

I know none of you floor nurses are like this...but where I work ,If they started making the ED nurses do the nursing admitting paper work on patients that are being held with us while they are waiting for a bed...... and then the bed came....but we did not have time to do that paper work because of the 5 traumas that came in(which I did have this past sat night)......we have nurses that would REFUSE to take these patients because we did not do THEIR paper work.....thus more delays for the patient...more back up for us....and YES they would get away with it.

We can forsee this problem so we do not want to even START it.

That's where I am coming from.

As my son would say,

PEACE OUT

micro, RN · Mar 21, 2002

massEDgirl............

peace and out..........

sometimes micro should read the forum.......emergency room nursing.......cause yo' mass.....I am not ER.........

and you do make very valid points.........

micro apologizes for overstepping her bounds.........

actually have the greatest respect for ER nurses..........

recently began workin on pulm.....unit.........a whole nother cup of tea.......and love it and learnin from the pros..........plus I have been around for a bit............

i can also respect your statement of

We can forsee this problem so we do not want to even start it.........

peace out,

micro