Crushing Burden of Regulatory Compliance on Healthcare

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Over and over I have seen hospitals spend vast amounts of resources and time on achieving Regulatory Compliance. Often the rules seem to have been cooked up in an office by officials who are very far from the bedside. The formulas that these people are using to develop policies seem highly flawed.

Some of the charting requirements are extremely cumbersome. Inconvenient workplace modifications and barriers turn the workplace into an obstacle course. Workers have many other requirements such as online education that often is meaningless, much of it being driven by regulatory and legal forces.

These burdens make the delivery of care much more difficult, without much tangible benefit,  except in what seems to be merely a theoretical way. Making systems more and more complicated each year doesn't lead to better outcomes. I'm not seeing that anything will be changing in the near future. Instead I think the burden will become too much to bear for the system at large.

Specializes in ER.
10 hours ago, Nurse Beth said:

LOL    My ability to tolerate nonsense is gone and I can't find it.

It has gotten beyond the pale. Covid exacerbated an existing problem 10 fold.

My facility was preparing for a big survey and accreditation. The things that became urgent were ridiculous. Laminating any paper notices, as if covid was just waiting to get on to a paper bulletin to bring humanity to its knees? Meanwhile there are staffing matrix problems that are serious, that the state doesn't care about. The facility has a huge problem in transferring patients from our remote location to a higher level of care. Yet we were obsessed with laminating paper instead.

Specializes in Tele, ICU, Staff Development.
3 hours ago, Emergent said:

It has gotten beyond the pale. Covid exacerbated an existing problem 10 fold.

My facility was preparing for a big survey and accreditation. The things that became urgent were ridiculous. Laminating any paper notices, as if covid was just waiting to get on to a paper bulletin to bring humanity to its knees? Meanwhile there are staffing matrix problems that are serious, that the state doesn't care about. The facility has a huge problem in transferring patients from our remote location to a higher level of care. Yet we were obsessed with laminating paper instead.

It's sad and ridiculous. I'm pretty sure it didn't help any patients.

Specializes in ER.
5 minutes ago, Nurse Beth said:

It's sad and ridiculous. I'm pretty sure it didn't help any patients.

Laminating paper bulletins did not save one life. It only took up valuable time and resources from more important things.

Specializes in ER.

I told the scheduler that 4 days a month would be a good base for me. I'll sometimes pick up extra, but I'm going to concentrate on developing my art furniture, with nursing being a side gig from now on.

Specializes in New Critical care NP, Critical care, Med-surg, LTC.
1 hour ago, Emergent said:

I'm going to concentrate on developing my art furniture, with nursing being a side gig from now on.

Best wishes in your new endeavor, art furniture sounds really cool!

One thing I found particularly ridiculous related to precaution changes after COVID at our hospital. Before COVID all patients with MRSA were on contact precautions. And if you had ever walked out of room with a N95 and then went into another room, you would be severely reprimanded. Then COVID came and suddenly, MRSA patients no longer need any kind of precautions. Was there some new research with this best practice change? Who knows. And your single use N95. Yeah, you can wear that for a month. The paper bag you put it in clearly has magical antibacterial properties that are keeping you safe. 

 

Specializes in Mental Health, Gerontology, Palliative.
On 6/18/2021 at 1:51 AM, Nurse Beth said:

LOL    My ability to tolerate nonsense is gone and I can't find it.

Not sure I ever had it to be honest

Specializes in Community health.
On 6/17/2021 at 2:18 AM, dream'n said:

In my job I do clinical note auditing to find the medical justification for particular testing, surgeries, etc. I frequently find that the notes don't include a date of service or even the patient's name, nevermind the actual reason they are being treated and the primary diagnosis. What I do find is a lot of unrelated items; fall risk, domestic violence risk, suicide risk, depression score, etc. while I can't even find the physical exam, PMH, PSH, recent vitals, related testing, and what's actually being done for the chief complaint. I realize that the questionnaire info is important (and is required by regulation/Joint Commission), but seriously, when someone is in the hospital for a GI bleed, I need to know the H/H, not the depression score.  Or if the patient has sepsis, I need the WBC count and lactic acid levels, along with their vitals and prescribed inpatient ATB, not the domestic violence risk score.  It appears that all of these regulatory questions are taking priority over the documenting of the actual pertinent medical information. 

One HUNDRED percent. 

I work in an outpatient clinic and it is the same. The visit note is pages and pages of PHQ9 score, tobacco screening, alcohol screening, anxiety screening (all of which were, in reality, just checked off by an MA who may or may not have actually asked any of the questions).  Then somewhere buried in the text is what the doctor wrote— “pt reports crushing chest pain today BP 200/120 recommended he go to ER pt declined left AMA.” Followed by auto-completed Covid education (“Pt was reminded to wear a mask and social distance”) and auto-completed “Pt was reminded to contact our office if symptoms worsen or change.”  

Specializes in ER.
41 minutes ago, CommunityRNBSN said:

One HUNDRED percent. 

I work in an outpatient clinic and it is the same. The visit note is pages and pages of PHQ9 score, tobacco screening, alcohol screening, anxiety screening (all of which were, in reality, just checked off by an MA who may or may not have actually asked any of the questions).  Then somewhere buried in the text is what the doctor wrote— “pt reports crushing chest pain today BP 200/120 recommended he go to ER pt declined left AMA.” Followed by auto-completed Covid education (“Pt was reminded to wear a mask and social distance”) and auto-completed “Pt was reminded to contact our office if symptoms worsen or change.”  

Those mandatory questions have gotten totally out of control. Yes, people just check them off. More garbage from regulatory that is notable only for its lack of accurate data and practical relevancy.

 

Specializes in Psych (25 years), Medical (15 years).
1 hour ago, Emergent said:

Yes, people just check them off.

I am a Professional Button Clicker, Retired.

Specializes in Psych (25 years), Medical (15 years).
14 hours ago, Emergent said:

I'm going to concentrate on developing my art furniture

Three Cheers!

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I am slowly cutting back my shifts/hours. I am winding down to retirement. I try to work less, spend less and live more. I am sick of this crap. It's time for a new generation to take on this fight. I am done to a crisp.

I have fantasies of being a barista or working at Lowe's. Except I can't lift that much weight. I think working in the greenhouse would be a dream if I could lift heavy plants and soil around. I love being around plants. People, well not as much these days. So many just suck.

I would rather babysit my grandbabies than anything. Nursing is not at all what it was in the 90s when I entered. Nor is medicine. It's all BS anymore.

Specializes in Med-Surg.

I tape a half sheet of paper to my computer on wheels every day that has when meds are do and other "to do's" and it really keeps me organized and reminds to do things.  

We are in the process of having a Joint Commission visit any day now and I was told that I couldn't use tape anymore. 

Meanwhile I'm being crushed by poor staffing and you're worried about me being busted by tape.  You'd best be worried about my mouth because I've lost my filter.......

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