Best quality care cannot be provided

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After working as an RN at a hospital for a month, I came to a realization that providing quality healthcare to patients is a total BS in this kind of setting.. When we as nurses, always in that rush mode.. We're being on charting, passing meds.. We have 5+ patients to chart on.. And dealing with unexpected disruption all day long.. Guess what.. This is money driven industry.. What I was taught in nursing school cannot be applied in real situations.. Is there anyway to cut on the charting and make more time available to actually be more attentive to patients? Am I wrong? Do you guys agree with me? Wouldn't it be a lot better to work with fewer patients and not feel overwhelmed that you want to leave on time.. I am really considering working in different setting. However. I will not be learning as much.. But I will be providing focused care.. I won't spend my day charting.. It's a shame.. Your input is welcomed..

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I came to a realization that providing quality healthcare to patients is a total BS in this kind of setting.
Once I came to that realization, I became fine with putting 70 percent to 80 percent of my efforts into providing the care.

I know the aforementioned statement may have sounded terrible to some readers, but hear me out. 70 percent is still passing. 80 percent is still passing. In addition, when I didn't put my all into the job, it led to self-preservation since I didn't burn out or take the negative aspects of the job home with me.

Some would say, "I don't want a nurse caring for me or my family who gives less than 100 percent!" However, that outlook is unrealistic because no stranger in healthcare cares about you or your loved ones as much as you.

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Do you do visiting nurse, or you stay in one home all shift long? I did homecare. I wanted to do visiting nurse.. But for now.. I will get some experience then move into another position that's less stressful..

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Specializes in ICU, LTACH, Internal Medicine.

Well, to begin with, perfection is hardly achievable in any area of human activity. So welcome to the real and imperfect life.

Second, it really depends on what one named "good care". I'd seen nurses who were constantly praised for the "perfect care" they gave while being almost intellectually disabled. These perfect nurses had no idea how to find their ways out of brown bag, leave alone figuring out why patient was going south. Everything they did were perfect charting, writing notes about utter nonsense, kissing policies, holding hands, giving nice talks about going to church, and THAT was what seen as "perfect care", by patients and Powers alike. Those nurses who rushed into room, figured things out and got them fixed got no such recognition.

Remember, not patients, nor Powers typically can recognize really good care even when and where it really exists. Just do your best and remember to be human- that is, making mistakes is ok, not learning from them is not. If you feel more and more upset about yoyr ability to deliver good care in that particular place, then think about changing area or unit.

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Thanks.. That's a perfect response.. Just doing the best we can and being human. To me. The most important thing for me is not making mistakes. I don't like to rush and end up regretting it. So it's all about doing the best we can.. Until another opportunity comes along

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What I really liked is school nursing.. You don't chart at all.. You sit there and students come to u.

Why would you not chart on each and every interaction you have with a student? How does the nurse cover herself in the event of a lawsuit? As to

just sitting there and students coming to you, I don't believe that's all it entails. School nurses can be tasked with some pretty involved care. There is also a fair amount of record keeping with regard to vaccinations and administration of medications.

I'm not a school nurse. Any here who can illuminate?

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I was a substitute, I wasn't permanent.. Yes. You chart name of student, little scrape on arm, bandaid applied. And the time.. . I'm sure there is a lot more work as permanent school nurse.. But they don't chart by body systems.. Like hospitals or other facilities..

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Specializes in Hospice.
That is the main reason I left the hospital, so I understand exactly what you're feeling.

I work in home health now where I do get to spend time with my patients, (which I really like) however the charting is still ridiculous! I usually end up spending 1-2 hours on charting after I get home in the evenings.

I'm considering another change...just don't know to what. Hopefully I can find something that's at least a little satisfying & doesn't bleed over into off time

That's one thing I love about Hospice. There's paperwork, but nowhere the volume found in Home Care.

My fervent prayer is that CMS never figures out a way to incorporate OASIS into Hospice documentation. [emoji33][emoji33][emoji33]

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Specializes in Cardiovascular recovery unit/ICU.

You may want to consider a higher acuity area like ICU OR CCU, CVR. You are with the pt all of the time and do everything for them. Yes, they are very sick but it's challenging and rewarding at the same time. I like the fact that I can know everything about my one or two pts. I round with all of the doctors and help plan their care. The floor is tough and I so admire these nurses! They have wonderful time management skills and knowledge of so many disease processes. For me I'm in cardiac recovery. The pt may have 6-10 drips to titrate or be on potable dialysis that I'm responsible for. Or a intra aortic assist device and ventilator. Both areas are hard in their own way. Find an area that suits your you and learn everything you can about it. The best of luck to you!!!!

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Thanks a lot for the reply. I'm working in LTACH (long term acute care) . Most patients on ventilators.. Critical drips sometimes.. I've always wanted to do med surge for learning more skills. But eventually I might end up on an ER.. I guess everyone eventually figures out where they fit

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I have over 20 patients on rehab floor, at least half are 2 assist with two aides on the unit, seems like nobody cares except me,can't possibly keep up, feel brain damaged by the end of my shift

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Specializes in Private Duty Pediatrics.
Well, to begin with, perfection is hardly achievable in any area of human activity. So welcome to the real and imperfect life.

Just do your best and remember to be human- that is, making mistakes is ok, not learning from them is not.

Exactly. :yes:

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Specializes in ICU, LTACH, Internal Medicine.

Just to let you know, acute LTACH can only be compared with ER in terms of spectrum of things you have to know and be able to do, and not with many ERs at that. I work in high-acuity LTACH, too :up:

You may be lucky if you find old-fashioned med/surg unit with no specialization and no "support" (i.e. you actually need to know how to fix wound vac before calling wound care and saying that it beeps). But such places become few and far between nowadays. I am doing my NP clinicals now in a hospital with no such units, and among good advices I'd got on my very first day was "learn which unit does what, and check yourself every single thing outside of the local range".

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