Acuity, cliques, paranoia, and documentation...

[WCSU1987]

Try to make this short and sweet. Acuity at work has been off the charts lately. Work inpatient psych been doing this close to 5 year's, 2 1/2 year's at this hospital.

We have had fights, restraints, police, so forth and on wards non stop for 3 week's. It's stressful for all working.

I am a bit concerned and worried work is building a case to get rid of me. So a co-worker and friend told me a nurse part of a clique of nurses that are close to the head of the unit criticized my notes. Friend said been doing it a lot more frequently lately.

Have no set criteria on how to write notes at work. At my old job we used D.A.R. Here we write a note and nurse signs it. However, if note is too many characters have to chop stiff, which can be tedious. I try to keep notes to the point but go over characters a lot. Off and on people complain. Most feel my notes are precise and not built with fluff. They are accurate and detailed to important events during that shift.

I am a little worried, tired, and questioning myself now. Feel I am not doing good work. Concern maybe being too aggressive with patients I don't know. I am worried.

Tomorrow just going to avoid details in my notes and good month. Now worried this is a trap sounds strange. That I'll get in trouble for not writing too much.

It can all be nothing I don't know.

Any advice on what to do?

Greatly appreciate it.

[Ruby Vee, BSN]

Try to make this short and sweet. Acuity at work has been off the charts lately. Work inpatient psych been doing this close to 5 year's, 2 1/2 year's at this hospital.

We have had fights, restraints, police, so forth and on wards non stop for 3 week's. It's stressful for all working.

I am a bit concerned and worried work is building a case to get rid of me. So a co-worker and friend told me a nurse part of a clique of nurses that are close to the head of the unit criticized my notes. Friend said been doing it a lot more frequently lately.

Have no set criteria on how to write notes at work. At my old job we used D.A.R. Here we write a note and nurse signs it. However, if note is too many characters have to chop stiff, which can be tedious. I try to keep notes to the point but go over characters a lot. Off and on people complain. Most feel my notes are precise and not built with fluff. They are accurate and detailed to important events during that shift.

I am a little worried, tired, and questioning myself now. Feel I am not doing good work. Concern maybe being too aggressive with patients I don't know. I am worried.

Tomorrow just going to avoid details in my notes and good month. Now worried this is a trap sounds strange. That I'll get in trouble for not writing too much.

It can all be nothing I don't know.

Any advice on what to do?

Greatly appreciate it.

Regarding the notes -- ask the nurses in the clique (one on one) if they can give you any advice about your notes. It may be difficult to summon the courage to do so, but it will help you in several ways. First, it's flattering to be asked for help. Second, you'll find out if you're making any egregious errors in your charting. Third, you can fine-tune your charting a bit. And fourth, it's pretty hard to complain about you when you're obviously working so hard to fix things.

An honorable manager who is working a case to get rid of you is going to be discreet -- so I wouldn't worry about that unless you hear it from your manager herself. If you have a talk with her, ask her how you're doing and what specifically you can do to improve. Ask for concrete suggestions, then follow them.

Good luck.

[Queen Tiye, RN]

Yes, asking how you can improve is good. Perhaps you can transfer to another unit or seek employment elisewhere if you still feel uncomfortable.

Also, do you think you might be burned-out by the high acuity and pressure from the nurses?