Article NY Times! Spot on...I think so!!

[NurseLRW]

[h=1]When Hospital Paperwork Crowds Out Hospital Care[/h]

Here is an opinion piece about how paperwork in a hospital can take precedence over patient care.

[Ambiguphobia]

Unfortunately, there's a lot of backtracking and repetition. There are care plans to write, as well as ticking off boxes to show performance of an assessment on the patient. Down the list for the assessment, we often run into the same exact question (eg; pts ability to urinate [incontinent], problems with urination [incontinent], pt voiding at this time? [incontinent]). Then, as we make a care plan for the pt, we check off more boxes to indicate they are incontinent, and say what we are doing to prevent skin breakdown. BUT during the skin breakdown section of the assessment, we tick off boxes that say what we did already (turn pt, clean as needed, provide barrier lotions, use incontinence devices, etc.).

Nurses have to stay late, sometimes for hours, to continue documenting, so they don't get in trouble. It has become pretty insane!

[Guttercat, ASN, RN]

Great little Opinion piece in that NYT article linked above.

Computerized charting is not the enemy. The enemy is in how it was conceptualized as a need in the first place...for capturing charges, increasing reimbursement (or at the least mitigating losses), and a firewall against lawsuits.

I like computers and technology, and adapt pretty well to it. My biggest gripe is that it inherently relegates the thinking part of nursing to time spent visually scanning a screen for "check yes or no" template answers. Don't think too hard, nurse, just find the most appropriate box to check as fast as you can, because you've got two more discharges to complete and an admit waiting in the ER.

[cayenne06, MSN, CNM]

My pet peeve- If I am logged on to my EMR, and open a patient's family history, clearly I have reviewed it. Why do I need to check the darn box to prove it?! Ugh. And what happened to charting by exception? Is it really better to have a PE that takes up a full page, listing every normal finding? Sure, the abnormals show up in bold, but I'd rather see a PE that shows a) which systems were assessed, and b) any pertinent findings.

Our EMR autopopulates the patient's med list with info from pharmacy databases. Which is totally great, except when i spend 20 minutes reconciling the past 12 months of patient meds, the vast majority of which were for acute, self limiting conditions. There's got to be a better way to utilize that information.

And omg, I get cranky every time I have to print out records and FAX them to another provider, so they can upload them into their EMR. There is no excuse for having EMRs not talk to each other- none. We totally have the technological capability to do so, and I wish EMR companies were mandated to provide interoperability. Or good lord. At least add a secure email function so I can just attach and send the darn record electronically.