Building a new hosptial...bedside charting...meds in the rooms?

[Pamelita]

HI !

you know we have computer bedside charting, cabinets in the rooms with all their po's, injectables and prn's!! its really great. You don't have to leave the room and you can watch your patients when you are passing and preparing your meds.

Also you can pull your antibiotics and leave them in their boxes so you don't have to walk up and down.

Computer charting is also very neat since orders are clear and progress notes are also clear.

Give it a chance :)

[deespoohbear]

I don't think we are going to have computer charting....that is one of my concerns...I can see if we had computer charting where the docs and whoever could access what they needed from the computer, but with paper charts will have stuff scattered all over the place...nurses notes here, flow sheets there, graphics here....high potential for something to get lost that way. That's what I mean when I say if they are going to do this, let's do it right and not half-azzed....

[whipping girl in 07, RN]

I'm glad I stumbled across this thread, since the hospital I'm presently employed at is planning to build a new heart hospital and the design that was chosen is much like the pod system that Dr. Kate and SallyICU_RN described. I just kept thinking as our director gushed over the beautiful plans (management words ) that they were trying to separate the nurses, keep us from seeing each other or talking to each other. I like my job and enjoy the patient interaction, but if I have two vent patients for three nights in a row, in a little pod all by myself, I guarantee you I will go crazy without having anyone to talk to, except for when I drag someone down there for the q2hr turns. Ugh, and what if my "podmate" is another nurse that I detest?! I realize I'm not there to necessarily have fun, but I'm not a robot. I'm not going to stay in a job if I don't enjoy it.

[Sally_ICURN]

Originally posted by konni

...that they were trying to separate the nurses, keep us from seeing each other or talking to each other. I like my job and enjoy the patient interaction, but if I have two vent patients for three nights in a row, in a little pod all by myself, I guarantee you I will go crazy without having anyone to talk to, except for when I drag someone down there for the q2hr turns. Ugh, and what if my "podmate" is another nurse that I detest?! I realize I'm not there to necessarily have fun, but I'm not a robot.

It would seem that it would be this way, but I find that there's so much to do that it's so nice to be able to give excellent patient care using everything you need at your fingertips. People are in and out of our rooms all the time especially on days...docs, families, RT, PT, OT, social services, etc., something is always going on. It's not quite as busy during nocs but the only time I really feel isolated is when I'm in a private room 1:1, but then again sometimes this is a nice break. The charge nurse rounds frequently for condition updates and if I ever needed ANYTHING from another RN all I have to do is call--we have what we call floats who are RN's specifically assigned to a certain number of rooms to help out and give breaks--floats are staff RN's on our unit and we all take our turn floating. Usually there's a CNA for the 29 beds on days but not nights and we do primary nursing. The RN's do it all--we are a very self-sufficient ICU. People socialize in suites and quite often nurses on break will go "visiting" into other rooms. I dunno, I suppose it could sound kind of socially stagnant, but really, I don't go to work to socialize and there's not a lot of time for it anyway...we're really busy! Fortunately, I have never felt as though our management wants to seperate the nurses, quite the contrary actually, I feel we are a strong, tightly knit group (including the docs) of professionals supported by our nursing management with a common goal...quality patient care.

~Sally

[angelbear]

What about HIPPA? Couldnt the pt's and their families hear everything when you are on the phone with docs or lab etc... Wouldnt that violate HIPPA rules? And wouldnt the constant interaction with families and visitors open us up to more questions from them that we are not allowed to answer? Also why do you need another nurse to verify insulin? Never heard of that here. Thanks

[Sally_ICURN]

Originally posted by angelbear

What about HIPPA?

Also why do you need another nurse to verify insulin?

HIPAA has not been an issue at my hospital that I know of....yet?

On my unit, we don't check insulin or heparin or anything other than blood products with another RN.

~Sally

[Allison S.]

Moses parted the sea, Noah opted for an ark, and I sometimes take the commuter boat.

I'm not sure how i feel about meds in rooms. It sounds like it is more trouble than it is worth. In our instance, it would also mess with our inventory control system (Suremed).

We are supposed to keep the flowsheets at bedside, but most days they end up piling up at the central desk. I like the idea of sitting down in the patient's room to give them a few extra minutes of presence while you document, though. Im not sure about standing at a shelf. I think that OSHA and the ergonomics people would have a field day with that.

We are about to start charting with rolling computers. Not only are there fewer computers than there are staff, but I can't imagine that the height will work for everyone. (I'm 6 feet.)

I have often thought that nurses need a locking cabinet in each room for supplies, etc. It would also help on those days when you have drawn up a dozen meds for someone who you then discover is reading Moby Dick on the toilet. At our facillity, it seems that the only acceptable place to store all those meds is in your pocket. yuck!

Good luck.

[deespoohbear]

Originally posted by Allison S.

Im not sure about standing at a shelf. I think that OSHA and the ergonomics people would have a field day with that.

Hey I never even thought about that issue. Something else for me to bring up.....Thanks!!!

:kiss

[plumrn, BSN, RN]

Just a quick aside from the thread, but I just wondered how it is elsewhere. Here we are taught in nursing school to check your insulin dose with another nurse after you draw it up, before you remove the needle from the vial, so that the other nurse can verify the type of insulin, the accuracy of the dose, and the expiration date.

This is even in the policy and procedure manual at our hospital.

Truly, I always thought it strange we are trusted to inject cardiac drugs, narcotics, etc., without checking the dose, but not insulin.

At least we can reverse the insulin if too much is given, but cardiac drugs, and others, possibly not.