Originally Posted by Chico David RN
Very good and interesting thread. I would add the one point that we are best and most effective in speaking out - not to mention safest - when we do it as a group with the support of a union behind us.
Fight on, brother! Just got called in to the manager's office yesterday; she'd received a call from the DON regarding our advocacy activities. Thank God for my union, CALIFORNIA NURSES ASSOCIATION. Without the just cause discipline procedure, advocacy language, and the law that's incorporated right into our contract, my advocacy could be tagged, "not a team player, not a good fit, doesn't get along well with others, or insubordination." It would have been, in the old days, BC--BEFORE CONTRACT; and I'd have been out the door with a black mark on my employment record.
We have a new computerized/electronic medical records/cpoe system that went on line last week. It cost management a lot of money, and I must admit, I didn't drink the Koolaid they were serving to toast the emporer's new clothes. Safer, more time with patients, accurate....NOT!
It seems they're getting tired of the collective sound of our union voice. And the patients and their families are noticing. "Who's taking care of the patients, all I see are doctors and nurses glued to a bunch of computer screens." OUCH!
Physician orders are incorrectly entered; treatment delays...hours and days have been the norm; pharmacy's not getting the meds out, computers are automatically populating data from the monitors onto the flow sheet even though it hasn't been independently validated by the RN. Was the mean BP really 30 on that craniotomy patient, or was the art line dampened, or was the patient being turned, or was the transducer on the floor? Who the heck's gonna remember when they're being sued because of a bad outcome, when the record is submitted as exhibit A, five years later in a courtroom somewhere?
The law holds us accountable for charting relevant and accurate data about our interventions and the patient's response to them. This system is an almost absolute barrier to our ability to do that. The administrations' bobble-head "champion super users" are available to help, they tell me. Sure, they're bringing in pizza, chocolate, fruit, and cooing, "how's it going, don't forget to breathe, we hear you" mantras.
They've diverted millions of dollars out of the patient care budget to pay for these "new clothes" the emporer is wearing, and they don't like it much when you tell them, "I don't see any benefit, only an increase in the potential for harm that can befall our patients."
We've collectively proposed solutions; we're not saying technology is bad. It's our duty and our right to protest the fact that they've pulled nurses out of staffing/away from the bedside, to try to make this system work. They imposed it on us in, "damn the torpedos, full speed ahead," fashion, and it's not safe for patients.
Management's interest is to put the best face on this in the interests of the business. Direct care RNs are advocating in the exclusive interests of the patient. We are advocating as professionals, to protect our practice.
Freedom of speech in nursing, backed up by documenting unsafe practices such as these, eliminates administrative deniability. The administrators will be held accountable for harm that befalls a patient when we document the fact that we've notified them of our concerns. Otherwise they say, "no one told us," or, "just do the best you can, and sign it anyway, we're working on it." Ha! Any one who believes they can protect their patients and their license in this commercialized, industrialized, proprietary system without a union like CNA/NNOC is delusional.
The bobble-heads' names aren't on the record, they're not licensed, and their frequent interruptions make us even more prone to making errors. They're not any help at all--keep your pizza, and don't come between me and my patient. I've got my whistle, and I'm blowing it.
As patient advocates, we're going to see to it that this new technology benefits patients and nurses, instead of just the companies/consultants who are selling it! We're going to ensure that it doesn't override the independent, professional clinical judgement of the nurses and doctors who are accountable for providing safe, therapeutic, and effective care.
WHISTLE-BLOWER PROTECTION. FREEDOM OF SPEECH. YA GOTTA LOVE MY UNION, CNA/NNOC. Join us!
http://www.calnurses.org/get-involved/ 