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Our hospital is going "online" in the second week of December-- All documentation is going to be computerized. I can hardly express how discouraged and depressed I feel since I received my four hours of training three weeks ago. On our med-surg unit, many of us are already drowning caring for 6-7 patients, with acuity not taken into account. Two RN's often work with two LPN's and must deal with their patient problems and needs not within the LPN's scope of practice, along with our own patients. The extra amount of work this documentation will take in addition to our patient care is just mind-boggling-- beyond the learning curve inherent in any new system. (Management is planning to "staff-up" for the first two weeks only as we get accustomed to the computers. Merry Christmas to us.)
I worked last night 3-11 shift, had 6 patients, 1 PCT (aide) for 14 patients, dealt with doctor calls/orders for the LPN, no time for dinner, stayed past 11:15 end-of-shift until after midnight to finish up, and all I can obsess about is that we will all be staying two hours overtime each night to do the extensive computer work, and I wonder how in the world I will be able to care for patients in any way but extremely basic in order to avoid staying late and missing dinner every night.
We're told that JCAHO is expecting hospitals to have computerized documentation so that they can more easily access information. Much of the additional documentation is clearly JCAHO mandated. But as it is right now, I rarely have time to update careplans or to check test results on our current, old-fashioned computer due to patient care needs. I realize that this technology is necessary and it will be helpful when doctors must write their orders on the computer by next summer, but I honestly don't know how I will be able to give decent care to my patients anymore with this added burden. As some may know from other threads, I've gone to upper management about med-surg ratios and am on a hospital-wide retention committee with only one result: They're giving us ONE extra PCT 3-11 for our entire 65-bed unit. Whoopdedoo.
I don't want to work anywhere else but med-surg; this is my community hospital and I want to stay there until I retire, but I'm not sure I can take one more burden-- And many co-workers are expressing the same feelings. Whenever I ask a nurse if she's taken computer training yet, this is the range of facial expressions I've seen:
:stone And yet all the hospital newsletters and other propaganda spins how "positive" the response to the computers has been.
I obviously have a negative attitude about all of this, but I'm feeling very defeated and overwhelmed by it. How many more nurses will we lose over this? I hope I won't be another nursing shortage statistic come January 2004. Any encouraging words, wisdom, or experience with getting through this at your own hospitals would be much appreciated. And I know that I must TRY to live out the first quote below by Rev. Swindoll:
Originally posted by 3rdShiftGuySounds 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!
Thanks for the encouragement, 3rdShiftGuy. I think I just now realized that I'm in the "Anger Stage" of grieving right now, that I'm grieving the loss of "the way things used to be", the fairly comfortable groove I've found that helps me get my work done and give good care. I'm certainly not at the "Acceptance Stage", and I DO feel like throwing myself on the ground and having a big ol' tantrum. :)
My LEAST time-consuming task on the job has been documentation. I take the patient's nursing flowsheet out of the charts, put them on my clipboard, write my assessments (mainly checking off boxes), and give report off of them. I know now that I'm going to have to "write twice", so to speak, in order to feel comfortable and to have information about patient assessments at my fingertips. Hopefully, I'll eventually feel comfortable enough with the computers to be able to access info I need quickly.
At some level, mentally, I'm telling myself, "You have to make this work." I know there are plenty of alternatives in nursing and in life, but I don't want any of them right now, so I'm feeling a little trapped, which doesn't help my anxiety.
I aspire to accept online documentation with grace and maturity and serenity, but I'm not there yet.
hmmmm... your computers or "meditech" equipment really does sound rather cumbersome.
The hospital I PRN at has small, flatpanel screens attached to a swing-arm that pulls out from the wall in each pt's. room, placed near the foot of the bed. They are now also attaching small computer screens/keyboard systems onto each med cart... kind of on a back panel type thing... now we won't HAVE to chart in the patient's room (yes, this CAN be disconcerting to patients and nurses alike... very "robotic" and impersonal... especially during the lengthy initial admission assessments.) This way we will be able to chart outside the patient's rooms as well.
Those monstrosities you guys are describing are totally absurd !!! :stone
Originally posted by KristinWWLet me clarify - at our hospital everyone is in favor of the new system. They just don't want to be live without training. A day of training certainly is fair, but they were given an hour and some not even that. The frustration rose while pts were screaming for meds, etc. and the nurses were sweating trying to figure out the new system with no one local to ask.
Oh, that is absolutely ridiculous. I'm actually planning to go in and practice on a computer some time this weekend to see if I can get more comfortable and familiar, since I don't remember much from 3 weeks ago.
Batmik, we're supposedly getting Pyxis soon, too, and our MAR's (medication administration records) will be computerized in March 2004, we're told.
Jnette, your in-room computers sound good. These C.O.W.s have to be plugged in every 12 hours to keep the batteries juiced, and we don't even have enough outlets in the hallways to plug them in!
RN- PA
Will pyxis be completely new for you? We have had it for controlled drugs for about 10yrs. In that respect it sure beats counting narcotics. We only do a manual inventory once a week on controlled drugs. The downfall of having all drugs in it now is getting Nitro tabs fast when pt having chest pain or other emergency type drugs. Also during busy med times 8a, 5p, 9p you have to wait your turn to get in the machine. Hopefully you get in line behind someone who can access their drugs quickly.
Good luck to you in the all the new things you are experiencing.
Originally posted by batmikWill pyxis be completely new for you? We have had it for controlled drugs for about 10yrs. In that respect it sure beats counting narcotics. We only do a manual inventory once a week on controlled drugs. The downfall of having all drugs in it now is getting Nitro tabs fast when pt having chest pain or other emergency type drugs. Also during busy med times 8a, 5p, 9p you have to wait your turn to get in the machine. Hopefully you get in line behind someone who can access their drugs quickly.
Good luck to you in the all the new things you are experiencing.
Yes, Pyxis will be totally new. And with your description, I'm beginning to hyperventilate. I think management is gonna need some aerosol Prozac for all us nurses on the unit once these changes occur. (And I pity the poor patients, too.... :stone)
Thanks for the info on Pyxis and for your good wishes, batmik.
Originally posted by mjlrn97My hospital went live w/ Meditech on Labor Day. What a mess those first few days were.......but at least we had tech support! Of course, I still question the logic of spending a huge amount of money and resources on a DOS-based dinosaur of a system....but that's just me.
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DOS-BASED???? I didn't think anything like that was made anymore. I guess next you'll be using stone and chisel for progress notes :)
Originally posted by KristinWWDOS-BASED???? I didn't think anything like that was made anymore. I guess next you'll be using stone and chisel for progress notes :)
We started a pharmacy computer program where we chart our meds and it is also DOS!!!
It is cumbersome. You have to mess around going from one screen to another - it drives me crazy.
Stone and chisel would be easier.
Oh for the days of being able to write on a piece of paper.
steph
Originally posted by KristinWWDOS-BASED???? I didn't think anything like that was made anymore. I guess next you'll be using stone and chisel for progress notes :)
Originally posted by LPN2Be2004At least the stone and chisel would not lock up and need a reboot
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Originally posted by stevielynnWe started a pharmacy computer program where we chart our meds and it is also DOS!!!
It is cumbersome. You have to mess around going from one screen to another - it drives me crazy.
Stone and chisel would be easier.
Oh for the days of being able to write on a piece of paper.
steph
DOS? What's DOS?
I'm pretty much a computer-dope except for surfin' the net. But those multiple screens sound like the nightmare we're experiencing. And constantly having to hit the "look-up" button for 50 million choices on pop-up "menus"-- Is that DOS? Why are they using such an antiquated, unwieldy system? $$$$$$?
KristinWW
465 Posts
Let me clarify - at our hospital everyone is in favor of the new system. They just don't want to be live without training. A day of training certainly is fair, but they were given an hour and some not even that. The frustration rose while pts were screaming for meds, etc. and the nurses were sweating trying to figure out the new system with no one local to ask.