Bedside charting?! Is this the new norm? VENT!

Nurses General Nursing

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We will soon be losing our nurses station where our desktops are located and will have to start using computers in the room to do bedside charting. I'm having very mixed emotions about this. We do not have COWs as the computers in the rooms are wall mounted and our back is toward the patient.

Is bedside charting becoming the norm? To me, it's very helpful to my feet and my sanity to be able to get off my feet for just minutes during the day to be able to sit and chart. Charting at the bedside when visitors are present, when patients are trying to sleep, causing us to stand even more just doesn't make good sense. Most the nurses on our floor are VERY unhappy about this change. There may be several nurses looking for another job. In fact, I've heard some nurses say "it's time to get out of here!"

I truly wish that it was a requirement for management to work in our shoes at least a week out of a year to see what we endure on a daily basis. Instead, they sit on their bottoms all day in meetings making new rules without consulting those of us that poor out the blood sweat and tears while performing our job every day!!

Specializes in ER.

This actually happened to me. We had bedside computers at my last job and I decided to use one of them to chart. When the manager rounded the ER, the patient and family complained that I spent more time charting than talking to them and that the chart seemed to require more attention than the patient.

The fact is, I otherwise would have recited the assessment questions and gone on and charted in the nurse's station with the same effect and no complaints. lol. As a result, I have NEVER EVER charted bedside again.

I also think its insulting to the nurses to chart "bedside." Sometimes, you need to sit and look at the chart for a second to really analyze what the patient's situation is and what you want to accomplish for the patient.

Also, all that logging in and out is inefficient. At least, the OP should have a WOW/COW to use.

"That nurse just stood there for 20 minutes and never even looked at ME! She stood there with their back turned....HOW RUDE!":madface: " I needed.....help, pain med, water, blanket....and she IGNORED ME:bluecry1:" That will increase the satisfaction scores....:banghead:.....NOT!]

Specializes in Trauma Surgery, Nursing Management.

I have mixed feelings about bedside charting. On the one hand, if you have touch screens, it CAN be faster to chart. One the other hand, it can also appear insensitive to chart on the computer with the pt right beside you.

One day I was shopping for some new Danskos at Nordstroms. (For those of you who know me, you know that I would rather have an enema than go shopping. I. Hate. It. But my puppy decided to customize my old Danskos by chewing off the heel...so it was necessary to get new ones.) I picked out a pair that I liked and the salesperson went to the back to find my size. She comes out a few minutes later with a similar pair, but not the pair I wanted. I try them on anyway, and she whips out her iPhone and starts texting. I was flabbergasted. I was thinking to myself, "Can you just stay off Facebook for 5 seconds while you are waiting on a customer for Pete's sake?!?!?" I did little to hide my thoughts while I looked over at my husband with this exasperated look on my face. When the salesperson finally looked up from her text-a-thon, she said cheerfully, "I just texted the main office to see if the shoe that you want is in another location, and we have this pair in stock at the store across town. Would you like for me to hold them for you? Or I could have them Fed Exed to you tomorrow." Ok...I felt like a jerk. I assumed that she was playing on her phone, but in reality she was providing excellent customer service for me.

I immediately thought of how our patients can misinterpret our bedside charting as impersonal. When our pt's roll into the OR, the first thing we must do is text page the resident/attending to alert them that the pt has arrived and they are needed for the pre-induction Time Out. Now instead of wordlessly logging on the computer to page, I ALWAYS say, "I am text paging your surgeon to let them know you are here" so the pt won't think I am playing video games or checking my email.

I totally feel your pain. And yes, I think that managers should always work a shift or two so they can stay in touch with the issues on the unit in a more personal way.

Specializes in ICU.

Im not sure why management cant be ok with you doing both. I find I can stay caught up better if I chart in the room, but I dont always want to chart in the room for the many reasone listed by others. Its creepy, they want to sleep, you get sore feet. Where are the docs going to do their rounds if theres no computers at the station? Doesnt make sense.

Specializes in neuro/ortho med surge 4.

All of these "rules" are made by people who do not do bedside care. Plain and simple. All managers, etc should have to work bedside and try to chart in the patient's room with family members and patients talking and asking for things incessantly. This is the only way to get our points across to management. We are always told we will get used to it or we are not using time management. I was once told I need to walk faster. I am one of the fastest walkers I know. I am 46 and can get into a room to answer a bed alarm before the 20 year old nursing assistant. Not to mention the shifts where I have literally run up and down the hallways to care for my patients. These types of statements infuriate me to no end.

As the old saying goes- No one cares until it happens to them- I think the managers, etc- all the way up to the CEO need to try to implement and experience their brilliant ideas to see if they are actually feasible before they start playing the blame game on overtime on the RNs.

Other than management experiencing this for themselves I see no changes in these absurd policies.

Specializes in Emergency, Pre-Op, PACU, OR.

I might be the odd one here but I like bedside charting, as long as nursing station monitors are available as well. It is unrealistic to expect nurses to be able to do ONLY bedside charting, especially in busy environments, but when it is possible, I found that my patients are happier with me spending more time in the room with them. I learned to talk/ask questions and type at the same time and I explain to the patients up-front that I am not ignoring them but that I am instead charting everything we will be discussing. My charting is as fast as it is if I was at the nursing station, probably even faster, more thorough, and clarifications with patients regarding med rec and medical history are much easier with the patient in the room with you. Feedback from patients so far has only been positive, they usually feel more involved in their care. Now, it would be nice if all the monitors in the rooms actually worked, but that is another story..

if you only have a few things to chart it isn't so bad, but when there's detailed charting and cover your A** charting to do, that would be stressful.

Seems like the people who come up with these ideas haven't had to do a lot of documentation.

In time they will learn that it isn't such a good idea ............when they start reading that silly sh*t thats gonna get typed because nurses can't concentrate in that situation.!!

I have a hard time with it too. i've gone back and read an admission narrative only to discover that i charted the pts bowel signs were even and unlabored @ 20 per min

!

I have a hard time with it too. i've gone back and read an admission narrative only to discover that i charted the pts bowel signs were even and unlabored @ 20 per min

LOL!!!!:D

"Funny errors you have made in charting" could be a pretty entertaining thread.

We started bedside charting in December. Our computers are mounted on the wall in the patient's room and our back is to them as we chart. I agree it's not ideal, but it is what it is. The whole system is converting over to real time charting. The expectation for us is that the patient assessment, iv site assessment, meds, I&O's, vitals and safety checks are done in real time at the bedside. This is in effort to reduce medical errors and improve patient safety. Once you get used to it it really isn't that bad and you do become faster the more you do it. Our patients have actually been very receptive and positive about the switch. I think they see how it benefits them by catching and preventing errors. We still have computers located in other areas for the more tedious charting (care plan, education, etc) and chart checks that we do after midnight every night. I can tell you that some of the older nurses really struggled with this, but have come to embrace the change and actually like using the system now. No worries!

I like doing some charting bedside, but not all of it. I try to chart initial assessment details immediately. Sometimes, that is not possible due to too many lights going off... I do some charting while seated as that does help reduce tired feet.

I like the idea of having a chair in the patient rooms for the nurse to sit on while charting. Also important to have working computers.

I think computers should be in patient rooms and at a nursing station...

I also agree with informing the patient about what you are charting and/or texting... this helps with them understanding why you are being quiet looking at the computer... I also let them know when I am reviewing their orders...as I am quiet for a good amount of time doing that.

Specializes in Trauma Surgery, Nursing Management.
I might be the odd one here but I like bedside charting, as long as nursing station monitors are available as well. It is unrealistic to expect nurses to be able to do ONLY bedside charting, especially in busy environments, but when it is possible, I found that my patients are happier with me spending more time in the room with them. I learned to talk/ask questions and type at the same time and I explain to the patients up-front that I am not ignoring them but that I am instead charting everything we will be discussing. My charting is as fast as it is if I was at the nursing station, probably even faster, more thorough, and clarifications with patients regarding med rec and medical history are much easier with the patient in the room with you. Feedback from patients so far has only been positive, they usually feel more involved in their care. Now, it would be nice if all the monitors in the rooms actually worked, but that is another story..

I envy you! I can't chart and talk at the same time. It used to drive me crazy when a rep would try to strike up conversation with me when I was trying to chart in the OR. I am simply not smart enough to chart with precision and concentrate on what the rep was trying to say. I finally had to just square my shoulders, tell the rep to go away and concentrate on my charting. I felt bad (because I could have been a bit more tactful), but I chart as if I am being deposed in court, and that requires every little brain cell that I have!

It is nice to know that bedside charting is working for you. Can you please hold a class for those of us who need pointers?!? :)

I can't chart and carry on unrelated conversation, either. I usually let people know what I am doing..."I am charting xxx...." and then "I am charting yyy..." that seems to help... I sometimes say, "give me a moment to finish charting zzz on you...and then I will answer that..."

Our hospital went with the "decentralized" plan a year ago, when we rebuilt. Meaning, no nurse's station. I call it the "Divide and Conquer" plan...reduce communication and solidarity between staff, and even between staff and providers.

All this technology is driven by a premise of a supposed increase in time at the bedside. It doesn't. All the nurses, doctors, CNA's and ancillary staff are stuck with their faces in the computers, handheld devices, locator devices, and phones.

I went in with an open mind, but what was once a health care community of people working together to solve problems, has been reduced to a poorly functioning, fear-driven, mechanical organism.

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