Crushing Burden of Regulatory Compliance on Healthcare

Nurses General Nursing

Updated:   Published

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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 Specializes in L/D, newborn, GYN, LTC, Dialysis.
3 hours ago, ThursdayNight said:

They'll fry people if they don't chart.

Got news for ya, we are fried already.

Specializes in oncology.
On 6/23/2021 at 7:56 PM, Wuzzie said:

Our newest is a financial screening. Seriously, I now have to talk to patients about affording the IV I’m about to stick in their arm. 

It's bizarre, isn't. I worked at a college where the students had to give us (faculty) their tuition check. I did raise hell about that and soon a registrar was appointed. 

Specializes in Retired.
On 6/23/2021 at 11:31 PM, Emergent said:

LOL, the folks in DC are a huge part of the problem. They have no idea how to dismantle a useless program or mandate. This problem is not going to get solved, it is going to get worse. The people in DC are so far removed from reality, it's a pathetic joke to expect them to have any thing to do with solving it. They are worried about one thing, the big businesses that pay their campaign costs and give them other goodies on the side.

Yes, I agree that DC is the problem but they caused it and they are the only people that can change it.  If the public were aware of the consequences of shortages, they might be contacting their representatives.  Funny how I NEVER see letters to the editor anymore from nurses expressing outrage.  But then, of course, we live in a country that doesn't read newspapers.  We are the largest health care profession and our political clout is out of proportion in a negative way compared to the doctors.  Why is that?  We need our own lobby on Washington.  Most nurses are apolitical and therein lies the problem. 

Specializes in Wiping tears.

They should have prerequisites to work as CNAs for at least 12months before they sit at DC. 

Specializes in Critical Care/ICU/PCU/Telemetry.

I can’t believe how far off the tracks our healthcare system has gone. I have been working as a ICU travel nurse since the beginning of 2019. I left my last staff job due to ridiculous short staffing, tit for tat write ups based on administrative whims, absurd expectations for charting, mandatory on call, education and meetings. I haven’t dreaded going to work as much as I did then, until this assignment. I have never experienced anything else like it, first of all the ratio is 3:1 which I thought was strange. The women who interviewed me stated that if I have a 3:1 then they would most likely be Step-down, as its a smaller community hospital and they often have to blend ICU and sicker step-down patients. My first day I knew it was going to be a mess. They required the agency nurses to attend their “new employee orientation”, take their quizzes, and do 80 computer modules! Why, for their “files”, after 3 8hour + days. I was given one day off, then on the floor on my own for next 3 nights. The second night I was scheduled as charge! They use meditech, have no tech on the floor, the vitals don’t crossover we have to manually enter them. There’s no rhyme or reason in patient assignments either . My third night I had a ED admit; a fresh vent on levophed. Three other patients including; a restrained pt, a very needy heparin gtt, and a dialysis pt. And it definitely hasn’t gotten any better, they have three core staff at night the rest of us our travelers. But admin will “round” on white boards, audit for pt rounding forms, fall risk, suicide risk, skin, that we asked for their family history on admission and flu and pna vaccination status! Are you kidding me, all we do is run all night long, cleaning, toileting, turning, passing meds ect. No one ever gets a chance to eat or drink unless it’s while you’re trying to chart. Thank goodness I am only there temporarily, but I feel terrible for the staff who have to live and work there. The hospital is part of a large corporate group, so paperwork and  administrative wants come before patients, staff, and relief staff. I am so done with this regulatory BS.

Specializes in Primary Care, Military.
On 6/18/2021 at 10:07 PM, JBMmom said:

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. 

 

When the pandemic first started, we were literally transferring patients from locations in the state with active infections to locations without active infections. Because they checked for open beds "in house" as a priority, and no one wanted to even consider that transferring around like this would only expedite the spread. I'm not talking about critically ill patients, but medically stable ones. When the concern was raised, management's response was "Well, they're screened for symptoms in the ER." Completely ignoring that the virus incubation could be up to 14 days, they were in the ER full of those who were ill and symptomatic and no actual testing was being done at that time. I was not surprised when the facility quickly had positive cases and multiple staff ill. In that inpatient psych setting, there was no such thing as contact or droplet precautions. The rooms and facility just weren't set up to support it. The flu would frequently sweep through and take out an entire unit. 

Specializes in Primary Care, Military.
On 6/19/2021 at 10:00 AM, Davey Do said:

I am a Professional Button Clicker, Retired.

Do you remember the wonderful required substance abuse and tobacco use mini-counseling required in the admission assessment for psych patients? How many times did that just get clicked through, especially for the acutely psychotic patients who aren't even able to participate in it. . . 

Also, our "quality control manager" would literally hunt us down if the patient's date, time, and exact description of their last meal were not filled in. God forbid if the patient didn't remember, or again, was acutely psychotic. Oh, and you better get direct quotes from the patient to include on their recovery plan, and it better be done immediately upon admission. They have to sign that, too, within eight hours. The stack of papers our patients had to fill out and then sign was huge. 

Specializes in Primary Care, Military.
On 6/30/2021 at 10:18 AM, lilmiz said:

I can’t believe how far off the tracks our healthcare system has gone. I have been working as a ICU travel nurse since the beginning of 2019. I left my last staff job due to ridiculous short staffing, tit for tat write ups based on administrative whims, absurd expectations for charting, mandatory on call, education and meetings. I haven’t dreaded going to work as much as I did then, until this assignment. I have never experienced anything else like it, first of all the ratio is 3:1 which I thought was strange. The women who interviewed me stated that if I have a 3:1 then they would most likely be Step-down, as its a smaller community hospital and they often have to blend ICU and sicker step-down patients. My first day I knew it was going to be a mess. They required the agency nurses to attend their “new employee orientation”, take their quizzes, and do 80 computer modules! Why, for their “files”, after 3 8hour + days. I was given one day off, then on the floor on my own for next 3 nights. The second night I was scheduled as charge! They use meditech, have no tech on the floor, the vitals don’t crossover we have to manually enter them. There’s no rhyme or reason in patient assignments either . My third night I had a ED admit; a fresh vent on levophed. Three other patients including; a restrained pt, a very needy heparin gtt, and a dialysis pt. And it definitely hasn’t gotten any better, they have three core staff at night the rest of us our travelers. But admin will “round” on white boards, audit for pt rounding forms, fall risk, suicide risk, skin, that we asked for their family history on admission and flu and pna vaccination status! Are you kidding me, all we do is run all night long, cleaning, toileting, turning, passing meds ect. No one ever gets a chance to eat or drink unless it’s while you’re trying to chart. Thank goodness I am only there temporarily, but I feel terrible for the staff who have to live and work there. The hospital is part of a large corporate group, so paperwork and  administrative wants come before patients, staff, and relief staff. I am so done with this regulatory BS.

OH OH! I KNOW THIS! The correct question, Alex, is what is HCA! ?

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