Drowning Nurses Given Cement Overshoes

KristinWW · Nov 29, 2003

We went online with a new system last week as well (although we wouldn't have had the nerve before our JCAHO visit). I'm not an RN yet but had the opp to view the same anger and discouragement from the nurses that you express.

They are overworked, tired, and had to beg for training. It was minimal, and they are miserable.

VickyRN, MSN, DNP, RN · Nov 29, 2003

Staffing issues aside (which are VERY serious BTW from your description), computer charting may actually be a blessing in disguise. Once you get used to it, it facilitates charting--with abundant use of "flow charts," easily accessible labs, etc. I hope your system will be streamlined with charting by exception. My advice--try to keep a positive attitude and give it 3 months trial just to be fair. If, after 3 months, you still think this new system is a bear and making an impossible job even worse, you can always resign. Change is always uncomfortable, but this change may actually be to your benefit. :cool:

SmilingBluEyes · Nov 29, 2003

YEP maybe a blessing ---it sure CAN be.

ONLY IF--- AND I MEAN IF--- we have enough computers so everyone can CHART in a timely manner. We are going "live" too, very soon, but LO! NO plans to increase the # of terminals at which we will chart. I forsee a HUGE problem here.....we have asked for more......so far, no plans....except to force us to "go live" soon.

but management won' t care...."just make do and live with it" is usually the motto.

Vicky when did you last work at the bedside? just curious....

RN-PA, RN · Nov 29, 2003

Thanks for your responses, Kristin and Vicky. The kind of sick thought that keeps me going is knowing that we're all in the same boat and misery loves company. The upset and turmoil that results from this may be the kick in the butt management needs to finally reassess and lower our nurse-to-patient ratios.

We will be charting by exception, but I was surprised to learn that when we have to write a nurse's note, we have to write it out with NO abbreviations whatsoever. No "Pt. OOB", no "BP" or others so commonly used now when we document longhand. (We know not to write "u" for unit and other abbreviation no-no's.)

Another problem is there is no training manual. They are changing and tweaking the system right up to the day this begins. Nobody knows how we're going to receive or give report, whether nurses will have to write in all of their own I&O's--- Oh, I forgot-- Intake and Output-- or whether the PCT's will continue that and so many other issues that show this system is half-baked at this point. Also, on each patient, we're to "document interventions" done each shift. You check maybe 15 out of 30 possible interventions performed on the care plan, and for each one, a box pops up where you have to check "yes" or "no" that the intervention was done-- Pure BUSY WORK!!!

I just got off the phone with my Mom and ended up bursting into tears as I told her about all of this. She wants me to go back on Paxil (I was on it for over a year a while back for anxiety issues at work, but I would prefer to not take it again for various reasons) or take Xanax prn in order to cope over the next few months. So I'm planning to call my Family doctor on Monday to explore meds to get me through this period without cracking up.

SmilingBluEyes · Nov 29, 2003

Hang in there, RN-PA. sounds like you are under a lot of stress, not just at work. Take care of yourself.

RN-PA, RN · Nov 29, 2003

Originally posted by SmilingBluEyes
YEP maybe a blessing ---it sure CAN be.

ONLY IF--- AND I MEAN IF--- we have enough computers so everyone can CHART in a timely manner. We are going "live" too, very soon, but LO! NO plans to increase the # of terminals at which we will chart. I forsee a HUGE problem here.....we have asked for more......so far, no plans....except to force us to "go live" soon.

but management won' t care...."just make do and live with it" is usually the motto.

I posted just after you did, so I'm just now seeing your response, SmilingBluEyes. We're getting "C.O.W.'s" or computers on wheels in addition to the desk computers. But when I saw them I asked, "Uh, has anyone tried to see if these will FIT in the patient rooms?" (They have a wide base, and I even have trouble maneuvering some of the wider-based IV poles between the end of the beds and chairs, not to mention, visitors' legs in the chairs.)

What kills me is the propaganda put out that says "Nurses will be back to the bedside with the new computerized documentation." :confused: Yeah, but all the patients will see is the top of our heads as we stare at our computer screens and type.

Originally posted by SmilingBluEyes
Hang in there, RN-PA. sounds like you are under a lot of stress, not just at work. Take care of yourself.

And I just saw this response from you, too-- Thanks so much and I will take care :kiss ; I know I need to be more positive, it's just that it's starting to feel like the final straw on the camel's back, so to speak-- And I only work part-time, for Pete's sake! But I've struggled with and battled anxiety issues since nursing school-- Thought I was doing much better, until now...

barefootlady, ADN, RN · Nov 29, 2003

Worked with meditech system for almost 10 years, NEVER got better. Had enough terminals, but sunlight prevented our use of some of them. Flow Sheets could have been useful, but too complicated with the way our system was arranged by the computer whiz. There was no natural flow from one issue, like glucose level from accucheck, to ssi coverage. Talked until we were blue in the face: result, more work, more interventions to check, NO natural flow. :devil:

:uhoh3: Hope your going live is better than ours was, lost weeks of on line charting to outspace, never will know if issues that we charted about during that time were ever recovered,

:devil: JCAHO needs to get into the real world of nursing before adding these requirements so they can better access information!

RN-PA, RN · Nov 29, 2003

Originally posted by barefootlady
JCAHO needs to get into the real world of nursing before adding these requirements so they can better access information!

AMEN, sister!

We also have Meditech, and they brought a consultant in to put together this huge system 5 months ago. I was asked to be on the computer documentation committee, but I wasn't willing to attend 2-hour meetings twice a week for 4 months. (The times didn't fit into my work schedule, either). Now I'm wishing I'd had the chance to give input, but they'd have wished I wasn't there. I'd have been beating my chest and causing problems from the get-go if I'd known what they'd come up with in the end.

And whose bright idea was it for us to go live 3 weeks before Christmas?

SmilingBluEyes · Nov 29, 2003

We went Live w/meditech at my last place of employment. those rollarounds they gave us were awful---huge, cumbersome, and stood between me and my patients, NOT very friendly. Know what I used to do? sit at their bedside, or do their assessments, jotting down essentials and THEN go back and chart them on the stupid puter. IT ATE MORE OF MY TIME THAN I CARE TO REMEMBER......!

NO WAY should an admission assessment be done on these things.......how can you build repoire with a STUPID orifice HUGE COMPUTER terminal standing between you and your patient??? Not to mention fitting the stupid thing in a room full of people, other equipment, etc. Oh and what a JOY looking for a place to plug the stupid thing in.

ANd further, you cannot use them in the halls....would be a HIPAA violation. WE all know that...but just TRY squeezin em in the nurses station, or having to wait to use a terminal that is already there. There has to be a better way some how......but I am a realist....

Oh yes, I know this much: Online charting is here to stay. We are not gonna escape it.

BUT I WISH THE POWERS THAT BE would at LEAST make it FEASIBLE, USER-FRIENDLY and EFFICIENT for those of us in the trenches that have to use these systems. IT IS A HUGE transition to begin with, one that is only more difficult when we don't have sufficient equipment or time to fargin USE IT!

Tweety, BSN, RN · Nov 29, 2003

We went online a couple of years ago and everyone said the same things you said.

It was a little tough at first. Some of the older nurses had never used a mouse. Some even threatened to quit. We lost only one nurse that I know of because of the computer. She was 65 and retired. And guess what, she came out of retirement to work one day a week and is using the computer just fine.

Sounds like you don't have any sayso in the matter. Try to open your mind just a little, accept the challenge, realize it's going to be tough, realize there is going to be a learning curve, but also realize this is the way it's going to be from now on.

You are going to be just fine. You may never like it, but soon you are going to be zipping through your charting the same as you are now. The computers may not give you anymore time, but the aren't in the long run going to take away any time either.

Take care and hang in there!

RNKPCE · Nov 29, 2003

Change is always hard. I can remember griping when we went from taped report to written report. About 5 months ago the hospital I work for put all meds in the pyxis. It was a very bumpy road the first month, definetly slower than the old way but now I like it. There is an added layer of safety for the patient as you can only obtain meds that are on the patient careplan without overriding them. In the past two weeks our hospital switched to new iv pumps with all new tubings and accessories. And the unit I worked on also was the first unit two weeks ago to start using the Cardinal supply stations (pyxis) for central supplies. It has slowed us down the last few weeks but we are hanging in there.

We were one of the first hospitals in the country to get computer order entry system in the 1970's. We still have that system which is now antiquated compare to the ones being installed now. The hospital has signed a contract with a company for a whole new computer system, I think the install for that has been delayed.

And in addition they will be breaking ground for a whole new hospital in 2005, expected completion date 2008. Talk about a big change.

I hope things go easier for you. If not don't make yourself sick over it by staying in a bad situation.