Disheartened by Profession Realities

[2BS Nurse, BSN]

I've been a nurse for about 10 years now. I completed the ADN, obligatory BSN (second bachelor's degree), took a board certification exam and have worked in three specialties. I LOVED the science (A&P, micro, patho, etc) and find myself going back to it for inspiration. Does anyone else out there feel as if we went to school just to eventually end up doing paperwork and charting? 

The challenge of nursing lies in multitasking and dealing with difficult patients and families. I long for the challenge of actually applying the science. We are so obsessed with patient throughput and keeping that money grossing machine turning. I had zero interest in studying finance. When I entered the nursing profession, I didn't anticipate the responsibility of perpetuating superfluous patient appointments (disguised as "lost to follow up") would fall on my shoulders.

[Davey Do]

My heart goes out to you, 2BS Nurse, in your truthful perspective.

44 minutes ago, 2BS Nurse said:

Does anyone else out there feel as if we went to school just to eventually end up doing paperwork and charting? 

It hasn't always been this way. Oh, there's always been a lot of paperwork that was exponentially compounded with the event of computer charting.

In my first ten years at Wrongway Regional Medical Center, before computer charting was put into effect, the time charting was much less. For example, I could do a complete admission assessment in 20 minutes. Seven years after the initiation of computer charting, completing an assessment admission in two hours was good time management.

It's a bummer that things are the way they are.

[TriciaJ, RN]

This brings back a memory of when my hospital employer switched to EMR.  One day I was in a patient's room, standing in one spot, waiting for the computer to fire up.  On a busy surgical floor, standing in one spot is a very stressful thing to do because there are twenty things clamouring to be addressed.

The patient's wife said "I bet having things on computer saves a lot of time!"  I managed a polite response "Actually, it doesn't." and got out of there before my head exploded.

[2BS Nurse, BSN]

Since the pandemic started, on site EPIC support has dwindled. I’ve gotten to the point of not caring about my charting because I can’t keep up with their emails.

[Guest219794]

There is an excellent book- "When we do harm" about medical errors, written from a doc perspective.

One of the topics covered is the amount of errors and poor patient care cased by onerous, redundant charting, and EMR.

[JKL33]

1 hour ago, hherrn said:

amount of errors and poor patient care cased by onerous, redundant charting, and EMR.

It's hard to imagine what things would look like if they weren't corrupted by other interests.

Much of the excessive charting people now associated with EMRs is a direct result of terrible, lazy and greedy decision-making by people whose primary concern is not patients.

For one example (of innumerable), there is a guideline/standard of care that certain patients should be screened for a certain thing. But someone comes along and says, "Well we need to just screen every patient because otherwise blah, blah, blah these dumb workers here won't know who to screen." So that documentation piece is built into the EMR and additional lazy and complicit people can audit compliance by seeing whether it was done 100% of the time or not. Next thing you know this is something that the department needs to accomplish 200 times per shift instead of 15 or 20. 

Then there's the time, energy and peace and well-being that is sacrificed in the name of figuring out why it was only done 60, 70 or 80% of the time. What will we do to get the numbers up! ?  Get angry. Threaten people. Write people up. All the angst, the drama.

 

[speedynurse, ADN, BSN, RN, EMT-P]

Yes, many times. When I was first considering the change from paramedic to nursing is that the main area that prevented me from making a change was all the stupid charting. It took me years to make the change solely because of this. Even now, I still get discouraged and have thought of going back to NP school to pursue more of the reason why I went into nursing. I would love to work at a rare disease clinic or genetics or pediatric cardiology. Our healthcare system has been bizarrely messed up for awhile and I don’t think it’s improving.

[2BS Nurse, BSN]

"Then there's the time, energy and peace and well-being that is sacrificed in the name of figuring out why it was only done 60, 70 or 80% of the time. What will we do to get the numbers up! ?  Get angry. Threaten people. Write people up. All the angst, the drama".

This! Primary care fighting with specialties about who is ultimately responsible for documentation. Management sitting back and watching the show.

1 hour ago, speedynurse said:

Yes, many times. When I was first considering the change from paramedic to nursing is that the main area that prevented me from making a change was all the stupid charting. It took me years to make the change solely because of this. Even now, I still get discouraged and have thought of going back to NP school to pursue more of the reason why I went into nursing. I would love to work at a rare disease clinic or genetics or pediatric cardiology. Our healthcare system has been bizarrely messed up for awhile and I don’t think it’s improving.

The NPs are responsible for just as much (or more) documentation. 

[Been there,done that, ASN, RN]

No. The challenge of nursing lies in your observation skills. It's up to you to watch your patient.. comfort your patient.. and do whatever it takes  to restore them to health.

 Nursing is NOT about what the nurse needs.

[2BS Nurse, BSN]

14 minutes ago, Been there,done that said:

No. The challenge of nursing lies in your observation skills. It's up to you to watch your patient.. comfort your patient.. and do whatever it takes  to restore them to health.

 Nursing is NOT about what the nurse needs.

Exactly. Unnecessary charting and tests will not restore them to health. In fact, a patient's mental health may decline once he/she receives the bill he/she cannot afford. 

[speedynurse, ADN, BSN, RN, EMT-P]

37 minutes ago, 2BS Nurse said:

"Then there's the time, energy and peace and well-being that is sacrificed in the name of figuring out why it was only done 60, 70 or 80% of the time. What will we do to get the numbers up! ?  Get angry. Threaten people. Write people up. All the angst, the drama".

This! Primary care fighting with specialties about who is ultimately responsible for documentation. Management sitting back and watching the show.

The NPs are responsible for just as much (or more) documentation. 

They are but they can choose to go to a private practice instead of a hospital practice. (As unfortunately it is the hospital systems that push the documentation approach).There are many doctors, NPs, and PAs choosing to separate from hospital systems and go to private practices where they feel they can provide much more quality patient care. The downside is insurance coverage is iffy. I have seen more and more specialists choose to do this - from genetics to GI to pediatrics to pain management. If I had the finances, I would absolutely do this.

[2BS Nurse, BSN]

3 minutes ago, speedynurse said:

They are but they can choose to go to a private practice instead of a hospital practice. (As unfortunately it is the hospital systems that push the documentation approach).There are many doctors, NPs, and PAs choosing to separate from hospital systems and go to private practices where they feel they can provide much more quality patient care. The downside is insurance coverage is iffy. I have seen more and more specialists choose to do this - from genetics to GI to pediatrics to pain management. If I had the finances, I would absolutely do this.

Gotcha. I am definitely seeing the large system side. I will check into an alternative! I do love spending time triaging and problem solving with patients.