Charting

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Specializes in Critical Care, Pediatrics, Geriatrics.

Is it just me...or does it seem as though computer charting for nurses is stuck in the stone age?!?! I mean, this is the age of technology, correct? And we seem to have a surplus of computer engineers/programmers, etc. in our jobforce. I just don't understand why healthcare computer charting, especially for nurses, remains so complicated....not user friendly in the least.

I worked at every hospital system, with the exception of the VA, in my Metro Area while doing clinicals during school. Each hospital had a differenct charting system...each with its own quirks and pitfalls. I consider my hospital's systems one of the best, yet it is riddled with flaws. I don't understand this. It seems like sooo much money could be made from designing a user-friendly charting system, especially if it was linked through multiple hospital systems where different facilities in different networks could share information.

Is there a specific area of nursing that focuses on this type of technology? I floated to our ER today and they have an AMAZING charting and tracking system, but it was designed specifically for the ER...it wouldn't work for the floors. In fact, we can't even access their system because we use a totally different system.

I feel like computer charting, in general, could be improved by leaps and bounds.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

My very first nursing job had completely paperless computer charting. My current workplace has the old-fashioned paper charting. Even though I consider myself computer literate, I possess an overwhelming preference for the old-fashioned paper charting. It is less flawed and more defensive.

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I feel that computer charting where I'm doing clinicals is very challenging... one wrong click and you just entered in incorrect patient info

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Specializes in Critical Care, Pediatrics, Geriatrics.
My very first nursing job had completely paperless computer charting. My current workplace has the old-fashioned paper charting. Even though I consider myself computer literate, I possess an overwhelming preference for the old-fashioned paper charting. It is less flawed and more defensive.

I completely understand this point of view. Many nurses on our unit complain because there are issues that arise, and they don't have an appropriate place to chart it...or the appropriate terminology to describe it. While computer charting is faster in most respects, it does have major flaws that could leave one vulnerable in a lawsuit.

I would be very interested in learning about how nurses are involved in the development and planning of new charting systems.

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Specializes in Critical Care.

Is there a specific area of nursing that focuses on this type of technology?

The subspecialty of nursing that focuses on this very issue is Nursing Informatics. You can even receive a MSN in this field. it is also possible to get involved on a BSN level. There are several programs that are out there and are up to date with technology. I understand your grief over this issue. In fact, the computer charting at my hospital is easier to use without the mouse. This seems insane.

However, you must realize that computer charting programs can not just be bought in the same way as a home office program. They are leased from the company that produces them. For this reason the cost of such programs are astronomical. Hospitals have to prioritize money in order of importance. Hospitals spend a lot of money to stay competitive in imaging equipment, recruitment, and building renovations. I would much prefer a pay raise than new charting. However, it would be great if there was an affordable 21st century charting program.

If this problem really bothers you, I would suggest getting involved in informatics. The pay is competitive and as we move on to the future the demand for nurses that can help develop software will be great.

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I've never done computer charting and fear it, I've heard pro's and con's but everything is going mechanical. What next? Robots?????

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Specializes in Critical Care, Pediatrics, Geriatrics.
The subspecialty of nursing that focuses on this very issue is Nursing Informatics. You can even receive a MSN in this field. it is also possible to get involved on a BSN level. There are several programs that are out there and are up to date with technology. I understand your grief over this issue. In fact, the computer charting at my hospital is easier to use without the mouse. This seems insane.

However, you must realize that computer charting programs can not just be bought in the same way as a home office program. They are leased from the company that produces them. For this reason the cost of such programs are astronomical. Hospitals have to prioritize money in order of importance. Hospitals spend a lot of money to stay competitive in imaging equipment, recruitment, and building renovations. I would much prefer a pay raise than new charting. However, it would be great if there was an affordable 21st century charting program.

If this problem really bothers you, I would suggest getting involved in informatics. The pay is competitive and as we move on to the future the demand for nurses that can help develop software will be great.

Thank you for this information.

Sometimes I get so frustrated with our system that I think its impossible a nurse could have been involved in its design.:lol2: I am very interested in learning more about this feild....there are so many areas that could use improvement.

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Specializes in acute medical.

We have computers in our hospital, but they are basically used for theatre lists, appts, location of patients, statistics :angryfire, handover sheets, and path/radiology results. We have been told that medication administration recording will be computerised, as will everything else. How do you have access to the different systems? Palm pilots?

With paper charting, it too is not infallible - I have been in an incident recently whereby an assessment sheet I completed had gone missing which had legal consequences. Thank God I had overdocumented and put the score elsewhere, thus proving I had done it....

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Specializes in Critical Care, Pediatrics, Geriatrics.
We have computers in our hospital, but they are basically used for theatre lists, appts, location of patients, statistics :angryfire, handover sheets, and path/radiology results. We have been told that medication administration recording will be computerised, as will everything else. How do you have access to the different systems? Palm pilots?

While many nurses, including myself, have PDAs...our hospital does not have anything that we can access with them. Everything is done on the hospital network.

Our order entry/lab entry is done with one type of software system. Our pt charting for the unit is done on another. ER has its own system for charting, tracking, and entering orders that is all rolled into one. None of these software systems are compatable with one another...or integrated.

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Specializes in Cardiology, Oncology, Medsurge.

According to rumor, my hospital had a law suit where the computer charting had disappeared, information glitch LOL Woe to the nurse who must defend her/himself with such baloney!

Pitfalls of the computer charting I've witnessed:

1. Not enough documentation by staff; assessment and nothing more!

2. Slow computer program...I mean someone go to Kmart and get us some memory!

3. Glitchy computer programs with things on the screen that should not be there...close to how it looks when one's home computer has too many bugs!

4. Down time during the night shift; Computers are up now; get all your late clinical naratives in! Yowweee!

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Last place I worked had computer charting, it was timeconsuming and inefficient. They ended getting rid of it after I left. Where I work now is getting it this year, and I'm sure it will be a PITA and annoy everyone.

I wholeheartedly prefer paper charting.

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Specializes in L & D; Postpartum.

We are using Watchchild for our Birth Center. Still learning, but what I realized early on and see more and more, is that I am probably doing less charting than usual, because it's just so bulky. I know the suits and clipboard people think it's great because it will make charts and trends and all that, but I KNOW I'm not charting as completely as I used to do on paper charts. We have a large selection of different pages to chart on and honestly, I"m so tempted to just chart everything I do under NOTE: you know like the old long note form we had back in the DARK AGES. Then if someone says you didn't chart this or that, I can say, yes I did, in the NOTE section. And it would be so much easier to check at the end of a shift to determine if you charted everything. Just yesterday I had to go in (day off) and chart some meds I'd given and had charted on the paper med sheet (we still have those) but forgot to do on the computer. What a PIA.

And slow! OMG! Our first computer at home was a Tandy 1000 in 1986 and what we have at work is no faster that the Tandy was. Putting in your user ID and password takes forever because the response time to a keystroke is forever. I can type an entry on the keyboard before it starts to show up on the screen. How efficient is that? I'm quite sure TPTB do not have slow computers in their spiffy offices that show no evidence of any real work. I walk past the partially open door of the CFO and I swear he's always in the same position, in front of his computer, nothing work related on the desk EVER; I'll have to see next time to determine if he's real and if not, hopefully the people who planted him there are at least changing his shirt and tie from time to time to make it look like his alive.

The computer charting is not saving me any time whatsoever and other than it's legible and that's only if you can find the right screen, it's not any more accurate.

Just my $.02 worth.

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