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:
Oh my gosh, Marie-- That Nursetoon's perfect! :rotfl: I will be printing it and hanging it up in our med room-- anonymously-- since I'm sure the humor would not be appreciated by managment.
DOS stands for disk operating system and it was used before Windows. It is usually text-only and doesn't have the graphics or flexibility of Windows programs. I cannot begin to imagine why anyone would be implementing a program that uses technology from the late 80's/early 90's.
When I was reading people's posts about wheeling big computers into a patient's room, I thought of what my husband does. He is a computer programmer and writes programs that are used on Pocket PC's, kind of like Palm Pilots but they do more. Instead of having to drag a computer cart around, it would be much easier to have a handheld computer with a small keyboard that you could carry with you. Perhaps he can develop a program for hospitals and then neither of us will have to work again!
Originally posted by VickyRN 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. [/b]
I really dont know how to take this statement....I agree about giving it a chance but the "you can always resign" part bothers me a bit. Yes, you could ALWAYS resign but isnt this the type of attitude that is somewhat responsible for the current nursing shortage??? "If you dont like it.......LEAVE!!!" They ARE leaving, in droves. If I took this message out of context I apologize.
I really dont know how to take this statement....I agree about giving it a chance but the "you can always resign" part bothers me a bit. Yes, you could ALWAYS resign but isnt this the type of attitude that is somewhat responsible for the current nursing shortage??? "If you dont like it.......LEAVE!!!" They ARE leaving, in droves. If I took this message out of context I apologize.
As long as administrators consistly leave nurses out the equation.
And as long as they consistly understaff nursing.
And as long as they make changes that endanger nursing licenses, paychecks and wellbeing
We (nurses) feel free to find greener pastures.
We do no benefit to Nursing by passively accepting dangerous situations.
Sometimes the best way to communicate with Administration is with our feet dancing out the door.
I take it to mean that this system is only a nursing documentation system and not a CPOE (Physician Order Entry System)...I wish JCAHO were as focused upon physician handwriting errors and system issues as a result to recommend using CPOE... that would cut down on nursing time spent taking and documenting orders and improve the system generally. MMB
We have had computerized charting for a couple or years now. I don't like it as well as paper...and it keeps changing. Our work stations bite too and I always have a sore neck and arms when I leave work.
I always felt like my documentation was more complete on paper vs. computer. At least with paper I didn't have to log-in to the screen saver, log-in to the desktop and then the program. Not to mention when the computers are down there is no way to access the info (vital signs, I/O) if a MD calls.
On a positive note, computer charting did get easier once it had been used for a while. I still prefer paper charting but I am dealing. I do like computerized MAR Kardex, much easier to read.
Medittech LOOKS like it's DOS based, but it isn't.
Here's there deal - Meditech CAN suck, or it can ROCK! Each facility decides how they want it to look, what they want it to do and how they want it to interact with the data entry person (Be that a nurse or anyone else) At our facility we have a whole team of about 40 nurses who meet once a month at LEAST (and usually twice) with the IT Nurse to work on development and getting things the way the NURSES want them! This makes the workflow MUCH more productive and the system is then able to actually reflect what we are doing with a minimum amount of problems for us! Each unit at our place pretty much has meditech customized for them to meet their needs.
If you have one non-clinical computer head doing all the work of customization (and I know this happens a lot in the smaller facilities) then yes the system WILL be cumbersome to work with. Get together with that person and tell them how YOU would find it easier to use. The wish "If only the system could do......" CAN be reality!
There are other charting systems out there - I have used one other. But I never found it to be as reliable. There is still much they can do to improve things, like making the interface more GUI and less technical, and making the hot keys and shortcuts more like those we are used to using in windows. That is now Meditechs biggest encumberment really. Now that so many nurses ARE computer savvy, meditech is very different from what they are used to using. It's no longer intuitive.
When I worked Med Surg and had 8 patients, I was GRATEFUL for the computer charting. It saved me time!!!!! It was just so easy to chart that pain med and note while I was standing outside the patients door in the actual moment, than it was to remember it later and have to go back and do it!
Be patient, know that you CAN have some input into how things function and I think you will find that you can do this with confidence!
First of all, I thank everyone for all your responses-- Very helpful even though many aren't too positive about the changes. (I AM looking forward to doctors' orders being typed in starting July 2004.)
Today on my day off, I went in to the hospital and spent almost 3 hours practicing on one of the computers. I thought I'd better get in there and see if I could make peace with the beast. I've also continued to grieve the coming loss of the familiar and fairly comfortable routine I'd developed with my documentation in order to have SOME time for my patients. I shed more tears since I last checked in here, and am getting much helpful advice on anti-anxiety meds and alternatives on another thread I started, if I decide I need to go that route:
I definitely feel a little more comfortable and familiar with much of the system after today's practice session. I checked out many of the menu look-ups to get accustomed to all the listings, and kept trying things to maneuver and negotiate all the various screens.
Gauge14iv-- I also wrote down questions and problems I had, to pass on to the consultant such as: Inability to go to previous field in a number of multiple menu look-ups (I'm sorry if the jargon is off-- hope you can understand what I'm trying to say); many common interventions that had directions on them in our current care plans like "I&O-- q8h" or "assess pain-- q4h", well, now the times aren't typed in-- We can always change the "generic" directions, but having to type in directions for 30 interventions will be ridiculous! Also, in many of the look-up menus for the admission assessment, there's a highlight bar you can scroll down and make check marks with the "Ctrl" button, and it was great to be able to choose multipe items quickly. Unfortunately, all of the look-up menus in the nursing assessments require you to type in the number of the description you're after--say, under the Gastrointestinal assessment, you need to click on nausea, tender, and distended, but if there are multiples in one menu, you click the number 1 for nausea, click "Y" for yes, and menu closes. You hit look-up again, type in number 4 for tender, click "Y" for yes, and menu closes. You click look-up key AGAIN, type in number 6 for -- Okay-- well you get the idea.
*sigh*
I know I can eventually figure out all the computer stuff as long as I can click on the "look-up" "previous field", "file" and "exit" keys. However, I still have one minor, itty-bitty, nagging question:
WHEN THE HECK DO I FIND TIME TO CARE FOR MY PATIENTS??? AIEEEEEEEEEEEEE!!!!!!!!
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.
Ah, this all sounds very familiar. I work at the same place.
Don't forget about the new pumps we just got. I wonder if there is a size limit on the learning curve... :-)
:stone And yet all the hospital newsletters and other propaganda spins how "positive" the response to the computers has been. 
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RN-PA, RN
626 Posts
Oh my gosh, Marie-- That Nursetoon's perfect! :rotfl: I will be printing it and hanging it up in our med room-- anonymously-- since I'm sure the humor would not be appreciated by managment.