Older nurses taking forever to computer chart

[Giga]

I've been working on the surgical floor for 9 months now and I'm starting to feel like I'm getting the hang of things on my unit. I've learned a lot of tips and tricks and my time management has really improved.

One thing I'm getting really frustrated with is that some of the older nurses take FOREVER to computer chart. And from my observation a lot of it comes from them not "knowing how to use a computer" the same way younger people do. To do a routine assessment on a total knee for example probably takes me 5-7 minutes, and that's not me rushing or anything and only talking about routine stuff. The same assessment would take some of these nurses anywhere from 30 minutes to an hour.

It's a little frustrating at times when they need help with other things because they used all their time "charting". Or when I need help but they can't help me because "If I leave this screen I might lose it and I've spent too much time on this!".

And truth be told I think maybe sometimes they're doing it on purpose because it gives the illusion of working, but that would be MEAN and I TRY to give everybody the benefit of the doubt.

[Spidey's mom, ADN, BSN, RN]

Fortunately we still have paper charting for nursing assessments.:redbeathe

When I worked acute, my shift was 0245 - 1515. We started our first assessment at 0400. Our hospital is small and we are in California so we don't have over 5 patients. I would go with the CNA, she'd do vitals and I'd do my assessment. When we were finished, I'd make sure all my assessments were written by 05. I don't like to postpone because you never know what the shift will bring.

Now I work hospice - still paper charting.

steph

[Spidey's mom, ADN, BSN, RN]

As an older nurse i want to have a simple answer for why it takes so long to chart,but its not always short and simple so perhaps i can take you through an example: A few years back i was involved in a lawsuit against the hospital by a patients family. This patient had a poor outcome, and the family was very angry (understandably). I will say that i consider the click/point three minute charting to be reserved for pts that are stable walky/talky progressing as expected in other words probable discharges. When i have patients that have change in condition usually a lot of narrative charting is included (aside from the drop/point/click). I will chart when the patients condition changed who i called, what they said, whether orders were given, what the outcome was of those interventions. Whether i needed to go up the chain of command (nursing supervisor/medical director) based on the md response. All of this is timed. As you can imagine its also time consuming.

In this particular example my charting was extensive. I cannot tell you how uncomfortable it is to sit at a conference table full of attorneys (only one of them being yours) and answer for the care you gave a patient years before. It was the thorough narrative charting on this particular patient, my interventions, reassessments,etc that got me dismissed from the lawsuit early (after the deposition). I think it was the time consuming charting that made it evident that the problem was recognized, steps were taken as ordered and still there was a poor outcome. Unfortunately, some of the people that subscribed to "speed charting" saw that lawsuit out to the end (a couple are no longer practicing nurses).

Based on this experience in my career my motto is "either spend the extra time as care is given, or spend it with a familys attorneys later".

This is so true. If you just do the "point and click" charting there is no detail to help you differentiate one patient from another.

Even in hospice, someone will mention a name and I will have to go look up the charting to remember.

A small example not related to nursing exactly is I kept a daily journal while in Vietnam while on a medical mission at the suggestion of a friend.

I re-read it a month or so after returning and I would never have remembered certain experiences if I had not written them down.

Amazing what the mind keeps and doesn't keep. So yeah, in case we ever have to go before a lawyer, it is best to document, document, document.

steph

[LouisVRN, RN]

I can totally empathize with your frustrations. On our surgical floor (maybe we work on the same one) several nurses routinely spend HOURS after their shift to continue documenting on their patients and as you said the documentation they do is nothing but routine assessments, no detailed notes/comments/narratives. Not only that but some of them chart incorrectly, implying things that they are not trying to by misusing the documentation system. All I can say is reach out to them, ask if you can be of any assistance. Maybe there is something they are not understanding but are afraid to ask for help. I have done this multiple times and it has made a tremendous difference. I can say one of the nurses now documents assessments correctly and leaves on time every day because of a maybe 5-15 minute discussion and some simple instructions. Better for her, better for me, better for the department/manager (financially) and better for the patients. Be an advocate for them and get them the help they need. :heartbeat

[RiverNurse]

Small font?Edit and increase the font.Hope that helps.

Not if it's in .pdf format... like the forms on our floor typically are.

[RNiel]

This can be a very sensitive situation. I'm wondering if instead of using the term "older nurses" you might has said "nurse's who lack computer skills". Regardless of the terminology, I know where you are coming from. Many people have suggested here that you try "helping" the struggling nurses. I have done that. I have gone out of my way to help them by making cheat sheets and books for them which include both quick references as well as step by step instructions. It has been helpful for some and others still struggle. Some refuse to quit writing every single thing down on a piece of paper before entering it into the computer. I feel very sorry for any nurse who worked in nursing for years, and years, and years because computers (at least where I work) were not gradually added. It was just suddenly in their faces and they had to go from learning how to log on to learning how to use a mouse and when to right or left click. It has been a huge challenge and very intimidating for many excellent nurses. However, the time comes where it isn't fair to provided easier assignments to nurses who can't keep up with charting. The computer isn't going away, it's a huge part of everyone's job now. If you are a nurse that is still struggling you have to take it upon yourself to go to your community college and take a class, or spend some time with a grandchild and ask them to teach you a few things. Heck, get facebook, it's a great way to communicate and learn at the same time. My heart goes out to everyone in the situation. I'm thankful that I am able to help some more "seasoned" nurses with the computer because they are always there for me when i have to draw on their experience and expertise, but sooner or later I am expected to know what I am doing too. It's a tough situation.

[Altra, BSN, RN]

Equating speed with quality is a common error of thinking in a beginner. And this new nurse is working in a management culture that allows new nurses to *cough cough* audit others' work and financially rewards them for doing so.

A nasty set up, with predictable results.

[Batman25]

I'd urge you to tread carefully, OP. You are a very new nurse and one who lacks any long-term experience at present. You might feel very sure of yourself right now but you still have a lot to learn. These nurses might lack computer skills but they could teach you a ton about patient care. They have seen more and done more than you have. Why not help them learn the computer? Why not use their knowledge in nursing to your benefit? There is a bigger picture here that you aren't seeing.

Your random audits also reek of discrimination. You are targeting certain people based on age. Stop it today. This may sound harsh but I implore you to concentrate more on yourself and your own abilities at present before you are fired or face other disciplinary action. I say this with your best interests in mind.

[aileenve, ASN, RN]

Hey I'm one of those "older nurses" (58) and the hospital where I work even let me train others how to use our computer charting, scan meds, etc.. go figure:confused:

[RNperdiem, RN]

My hospital trains a few computer "superusers" who receive extra training in the computer charting and serve as a resource to other nurses.

Perhaps you could volunteer for that?

[umcRN, BSN, RN]

I have noticed some of the older nurses struggling with the computer a bit but I AM SO GLAD they are there when I go running to them with a question. I'm happy to help if they have a question with computer charting. It's a win-win situation and eventually we will both be that much more knowledgeable. Shoot...my fear is down time on the computer and having to paper chart

We had down time for 48 hours once, out of the blue, Let me tell you I was running to those nurses who had been in the unit 30+ years. I am very glad they are there

[joanna73, BSN, RN]

To the 27 year old poster on the previous page who was attempting to be helpful by suggesting that these experienced nurses might benefit from a "5 to 15 minute discussion" regarding their charting habits....lol, are you joking, too?? That sounds very arrogant as well. I cannot believe that people actually have this much disrespect for their elders. Wow.

[Giga]

I've read all the replies from people telling me that I need to reexamine my own priorities and that "there's no wonder they won't help me". Them helping me isn't really the issue, it's them making me do task for them because they're pussyfooting around on the computer.

Also let me make it clear that they are NOT spending additional time with patients, they're spending their time sitting behind the nurses station slowly drinking coffee while slowly punching keys one at a time at the computer.