Difficulties in Patient Care and Identification

Nurses General Nursing

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As a nursing prospect and student, I was wondering what the common issues with identifying rooms and patients are in the workplace.

From a psychological stand point humans are innate to missing cues in high stress situations. Stress causes anxiety which can cause mistakes and confusion. To overcome these anxieties, devices like notes, or psychological reminders can be implemented. However, in a data heavy and personalized environment it is very common to miss information or misinterpret information. Especially in distinguishing a patient.

In such a high paced and dynamic environment where time and service is key, what makes it hard in identifying patient rooms? What makes it hard to distinguish the medical precautions that are to be taken when entering a patient's room? What indicators, or visual cues make it easier in distinguishing specific patient rooms?

Specializes in SICU, trauma, neuro.
However, I am focused on the precautions side of the room identifications. In many hospitals there are still signage and documents that notify nurses and doctors of precautions to take when entering a patient's room[/Quote]

Ok, just saw this part. We too have the contact/droplet/airborne signs on the doors. I don't need reminders for MY assigned pts. However we enter other nurses' pts when they are tied up or on break -- you can bet I look at them, because I don't know their history. If they're not assigned to me, I haven't taken report. Plus, the signs are for the benefit of visitors, for non-clinical staff (e.g. dietary or housekeeping staff), for consulting physicians who are typically not located on our unit.

The signs work fine. I don't see the need to improve on them because they are not a problem. They convey the necessary information to EVERYONE entering the room -- not simply those who have been in the chart to see the "Contact precautions: MDRO"... or those who know, say, a color code used by a hospital in lieu of the actual information. The directions, such as "gown and gloves, wash hands with soap and water" for C. diff, also spare the nurses from having to intercept Every. Single. Person approaching the room to TELL them what they need to don.

I honestly don't see a problem to be solved.

.....also spare the nurses from having to intercept Every. Single. Person approaching the room to TELL them what they need to don.

And with that you have just identified another never-to-be-addressed issue that pertains to "healthcare"-associated infections.

JKL33, I completely understand your premise. I definitely agree that more employees on a shift would solve a lot of the issues we and many others face in the industry. However, from a business and management perspective, that is not a feasible solution for our current time and environment.

What I'm trying to understand is what causes stress or discomfort on nurses during their shifts. What are issues that cause mental or physical distractions and hindrances?

I'm looking to update our technology so that our staff is not overworked, and to create methods of easing the stress of having to manage a large amount of data for all the patients being cared for in a given unit's environment.

I also agree that a lot of administrator and management "solutions" most commonly do add more problems. That's why I want to understand from those who work in that given environment what the real issues are in their workflow. I want to avoid the generic and stereotypical effect of administrators adding more problems.

JKL33, I completely understand your premise. I definitely agree that more employees on a shift would solve a lot of the issues we and many others face in the industry. However, from a business and management perspective, that is not a feasible solution for our current time and environment.

I will need more time to think about the remainder of your post.

In the meantime, please think about this. You have told me that my solution is not feasible from a business and management perspective. I must ask if you understand that there are now entire departments of "fake problem solvers" and entire industries that have cropped up to solve the fake problems. So I will take it that you don't mean that my solutions are not feasible from a financial stand-point, but rather simply from a "preferred theory" standpoint.

I'll give you an example.

Patient satisfaction. I can think of probably a handful of practices and/or interventions that might get us somewhere with patient satisfaction. I have even wasted my breath by suggesting some of them IRL.

What we would apparently RATHER do, is have nurses speak in stilted and scripted phrases, perform treatments that patients don't really need (please think about that for a second!), and write nice-sounding things on whiteboards.

Here.I.Stand, it's not the identification that I believe is stressful. I agree that memorization such as room numbers is quite easy and common sense. However, with the added stress of a patient care environment, it can cause memorization to suffer from the continued stack of daily requirements and workflow.

If you do not believe new technology or cues are needed to ease memorization and decrease forgetfulness, what do you believe can limit the stress of a patient care environment on employees?

Specializes in SICU, trauma, neuro.
And with that you have just identified another never-to-be-addressed issue that pertains to "healthcare"-associated infections.

I don't mean that as in we don't have to educate, but when you are in a room caring for a pt? You wouldn't even see the visitors coming to see your other pt on contact precautions. I know I don't see every single visitor coming and going. With specific instructions, they have some guidance on what to do to help prevent the spread.

Here.I.Stand, with these precaution signs are they intuitive and secure? Is anybody able to change the precautions on the door? Is there any security measures to keep others from tampering with the precautions on the sign?

Specializes in SICU, trauma, neuro.
Here.I.Stand, it's not the identification that I believe is stressful. I agree that memorization such as room numbers is quite easy and common sense. However, with the added stress of a patient care environment, it can cause memorization to suffer from the continued stack of daily requirements and workflow.

If you do not believe new technology or cues are needed to ease memorization and decrease forgetfulness, what do you believe can limit the stress of a patient care environment on employees?

Can you share your experience in patient care? Because I am truly not familiar with this stress-induced brain fog you are talking about.

What can limit our stress? Appropriate staffing. Not minimally safe staffing, but sufficient to be able to count on leaving on time -- no late charting that we didn't have time to do during the shift. Sufficient to be able to take our breaks without worrying about the floor, without feeling like "I'm just getting further behind." Sufficient for the management to staff the floors. Nurses should never have to work mandatory overtime, or worry about being penalized for calling in sick **when truly sick.** Sufficient to give us enough time to provide proper patient education. Sufficient time to provide high quality treatments -- not leave a soiled dressing on a person or skip a bath for lack of time.

I'm not anti-technology at all. What I am saying is you are addressing a non-existent problem.

JKL33, thank you for clarifying. You are right, it is feasible but it is not preferred. It has been made clear to me that my institution is not trying to employ more nurses for shifts, if possible. Thus, the reason why I've gone in search of different methods to help ease the workflow.

Also, what are the practices that you've suggested in the past? What do you believe is best to optimize patient satisfaction while limiting the stress of our staff?

I don't mean that as in we don't have to educate, but when you are in a room caring for a pt? You wouldn't even see the visitors coming to see your other pt on contact precautions. I know I don't see every single visitor coming and going. With specific instructions, they have some guidance on what to do to help prevent the spread.

I understand/stood. What I meant is that not all infection risks found in hospitals actually stem from hospitals and/or healthcare workers.

Specializes in SICU, trauma, neuro.
I understand/stood. What I meant is that not all infection risks found in hospitals actually stem from hospitals and/or healthcare workers.

Ah, gotcha. :)

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