Best quality care cannot be provided

[uniqueguy34]

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..

[GoodKick01]

Every business is money driven, and hospitals is the machine to make money. We as caregivers must do whatever takes to make the money. The ratio can be a difficult criteria to judge the quality of patient care. They can make you do more if you have fewer patients or do less if you have more patients. Patient care does require time and it is the thing I need the most. Time is essence but it is never enough! I heard nurses in California has better working environment.

[dedicated_2b_RN]

a lot of talk about this problem going on here WHAT IS THE ANSWER How many people have died because of all this BS from administration

*** How can Nurses as a group address this issue to someone who can solve it and make the money grubbers see lives are in danger does money really make administration blind I HAVE A SOLUTION require all administration to be an RN in order to work in administration

also require administration (who would be required to be an RN ) to do bedside 8 hours a month

[Axgrinder]

Sadly, charting will never vanish in order to allow us to interact with pt's the way we should. It will only likely increase.

I feel your pain and disillusionment.

[twetekitty]

If you find that job, let me know. I'm seriously considering going and working at the local plant nursery. !!!!

[Penelope_Pitstop, BSN, RN]

Everyone who works at bedside agrees with you. Those in the office do not. So what should you do? Go to the office.

I'm in the office.

It ain't always sunshine and rainbows...

[twetekitty]

Honey try the new typical ICU assignment... 3 ICU patient's is becoming the norm.

[hotwaterbottle]

My mother had a hospice nurse who used to come to her house once a week when my mother was dying. The nurse was young but had tried hospital work also. She said she would never, ever go back and was very happy doing the hospice work.

Also, I've worked on a child psych unit and we did spend a lot of time with our patients. Although it's a very different kind of work.

I would recommend staying in the hospital setting for a while to gain knowledge and experience, then transferring to a different setting (like hospice, home care, or child psych) where you don't spend all of your time charting.

[margin261]

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]

Ughhhh- OASIS is dirty word! Lol!! I really hope CMS doesn't do that to y'all! It truly serves no purpose.

I loved hospice when I was doing it, but the company I was with...not so much. I really wish we had inpatient hospice facilities in my part of the world but we don't.

And I did put in my notice with the HH agency yesterday. I have my hopes set on a clinic job that would be 7days on/7 days off- time to actually have a life! What a concept!

[uniqueguy34, BSN, MSN]

Thank you.. Very true what u said. In fact it's getting better and better. My hospital hired 30 nurses recently.. Most of them no previous experience.. Theyre improving the ratio.. And good thing about ICU is that patients aren't demanding.. So.. I'm sure things will get better..

[feelix, RN]

That is why nurses need to unionize. I know you say the word union and people start bristling, but when you have no voice you need to band together. I know union dues cost money, but they help you stay longer in the game. Right now unions are lobbying in congress to control patient to nurse ratios. None of us has the money to hire lobbyists on our own. Think again if you think union dues are expensive. ANA and other organizations have done **** for nurses so far. Tell me one bill they helped pass.

[Chaya, ASN, RN]

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.

I can't remember the details but not long ago saw a couple of studies that estimated that after administrative duties nurses spent like 60% of their time doing actual patient care. So 70-80% would be a very significant improvement.

I found that the nursing skill most valued above all others in corporate health care is "time management", meaning be prepared to absorb extra duties and patients above and beyond what is outlined in your job description and what you may feel is safe for your care setting. In my experience staying late to chart, especially if it causes you to consistently clock out late and therefore appears as overtime hours, is seen not as being conscientious but as having poor time management skills. (Just saying!) :)

[nutella, MSN, RN]

My mother had a hospice nurse who used to come to her house once a week when my mother was dying. The nurse was young but had tried hospital work also. She said she would never, ever go back and was very happy doing the hospice work.

Also, I've worked on a child psych unit and we did spend a lot of time with our patients. Although it's a very different kind of work.

I would recommend staying in the hospital setting for a while to gain knowledge and experience, then transferring to a different setting (like hospice, home care, or child psych) where you don't spend all of your time charting.

I think you have a wrong impression of home hospice and home health. Both jobs require huge amount of documentation and not just a quick narrative. Charting is computer driven with software that does not allow any short cuts and if you do so - quality calls you in. Hospice documentation used to be less but with new requirements from CMS it is now a long process and all home care/home hospice is especially long when you admit or re-certify...

Plus I had more frequent visits in home hospice than once a week. In fact, when somebody is close to dying I went out every day to that patient/family. Plus on call and such...