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:
We have had computerized charting for several years. I have mostlygotten used to it except for the medication section. It's such a drag to be able to see only 3 meds at a time, and I think dangerous too. And when the system goes down, there you are with meds to give but no safe way to do it.
The other part I don't like is having the computers in the room. I have visitors standing over my shoulder reading the information in the computer, and it seems rude to me to be focusing on the computer when the patient is trying to talk to me. Also quite time-consuming. While you are standing there charting pts. and visitors are chattering, which is distracting. When not talking, they are thinking up little errands for you to do. Now I don't mean to say I don't want to take care of my patients, but I already don't get meals or breaks and am always late getting out. I just don't have time for fluff and tuck until the safety issues and the nursing-license issues are met. All in all, I think a good electric typewriter in the nurses' station (I mean interdisciplinary module) would have done better.
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.
AMEN!!
It never fails to amaze me how usually, the people least likely to be affected by this kind of change are usually the biggest cherleaders for it.
I'll never forget when a homecare agency I worked for went "live." Suddenly, an admission that took 10 written pages required over 100 screens to complete. Yes, we lost nurses over that one.
And as far as "training"...one or two days in a computer lab doesn't make you proficient. And they expect you to hit the ground running once you're done with training...forget about a learning curve.
Like it or lump it...yeah, that sounds about right.
PS: You should not have to take time on your day off to be learning the computer. The hosp. has a duty to train you; you do not owe them your days off.
PS: You should not have to take time on your day off to be learning the computer. The hosp. has a duty to train you; you do not owe them your days off.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Originally posted by fab4fan
PS: You should not have to take time on your day off to be learning the computer. The hosp. has a duty to train you; you do not owe them your days off.
RN-PA I feel for you. I was in your shoes last year. Our hospital went live w/ Meditech. I can't say I like it, but I have gotten used to it. We even had some per diem staff quit over it. It is very time consuming. I work in OB, so we have another system Watchild which we also chart in. It doesn't communicate w/ Meditech. Part of what is frustrating is the sheer volume of info. we are expected to extract from our pt's. I am thinking we will soon have to find out if the vehicle that brought them to the hospital needs tires or an oil change and schedule it for them prior to dc if it does. Hang in there! I am praying for you. It is rough and I am one of the staff that is "good w/ computers". We have those roll-around computers on wheels. We had C.O.W.s back in the '80's too, but they were commodes on wheels, not much different, just more cr*p for the nurses to take care of! I don't like the charting by exception too much myself, but I've adapted. The hard part is when you roll that COW in there, the pt. may feel like you are paying as much attention to the computer as you are to them. It will get better. Personally, I still prefer pen and paper, but it wasn't my idea. It would've made no sense for admin. to consult the staff before spending many thousands of $'s on a computer system. You know when I win powerball or take over the world, it will get much better. Try to keep your spirits up in the next few months. it will get better. Make a conscious effort to do some fun, stress-relieving things outside of work in these next few months:chair:
We use meditech at my hospital, and the more you use it, the easier it can become.
I know what you mean about the abbreviations and using the look up key, but you'll learn those VERY quicky...trust me. It does save time too. For example, my GI assessment typing looks like this:
s (enter) g (enter) nt (enter) g (enter) n (enter)
it shows up as:
soft
generalized
non-tender
generalized
normal (bowel sounds, that is!)
All that info in six easy letters!!
One more tip before I start sounding like a meditech saleswoman :chuckle
When doing your assessment, write the things that are ABNORMAL, this way, you just need to make sure those things are in there. For us, you can "recall" what other nurses have entered by using shift and F5. Saves lots of time (it took me 10 minutes to chart on all 6 patients today!)
Good luck, and I'm glad you're recognizing that it's ok to be upset by changes, but crying and having a lot of anxiety are indicative of a whole other issue!
While staffing issues are a problem everywhere (As a tech, I average 12-20 patients on a telemetry unit), I think, computer charting can be time benificial when you get past the initial 'getting to know you' part. I worked with meditech at a past hospital and am currently working with a newer program. The one I am currently working with, Care Manager, is newer, and IMO is better, but when we first went live was horrible for the first few months while they were working out the bugs and people were getting used to it. Just hang in there and eventually, once you get used to it, you will see it's benifits.
imenid37 - it sounds like the trouble is with the powers that be at your place who decide what should be required info for your charting system....Join that committee!!!
Meditech is basically blank and each facility and even department gets to decide what is there to be assessed or entered. Then Meditech is "built" the way they want it. So someone at your place decided they needed twice as much stuff as they did on paper.
Not that I love meditech, but some things CAN be fixed!
As for the 100 screens for a home health admission - I used to do home health and we looked at software like that - we didn't buy it!!!! There were other programs out there that did better than that. 60 some odd screens I think - which beat filling out 28 pages of paper that we had with lots of redundant and repetive info. After doing an admission, I had most of my patients full names, socials and addresses and phone numbers memorized because I had written them 11 times.
PS: You should not have to take time on your day off to be learning the computer. The hosp. has a duty to train you; you do not owe them your days off.
I got paid for the time I came in on my day off to practice and become more familiar with everything; I'd received the 4 hours of training, but that was almost a month before I'll be working "live"-- TOMORROW!!!
Originally posted by ChicagolandRN
Good luck, and I'm glad you're recognizing that it's ok to be upset by changes, but crying and having a lot of anxiety are indicative of a whole other issue!
The "whole other issue" is the topic of this thread. I was already having trouble dealing with our nurse-to-patient ratio on 3-11 shift, high acuity patients, caring for problems the LPN's patients may have, and staffing "holes". The "cement overshoes" for the already drowning nurses is the computer documentation. As it was, PRE-computerized documentation, we weren't getting breaks or meals, and I barely had the chance to do computer work in the previous system because of all my patients' needs and the activity on our shift (transfers, admissions, post-ops, etc.).
Our PCT's are being loaded down as well with inputting all of their vital signs, documenting care, I&O's, etc., when we're counting on them to give the care to patients we licensed staff will not have time for.
So yeah, I've got stress and anxiety issues. I am heading for a doctor's appointment in one hour to request anti-anxiety meds. to get me through this time. After talking to nurses who have worked this week so far, I've reached the conclusion that I'm not going to be able to make it without help, unfortunately.
:stone And yet all the hospital newsletters and other propaganda spins how "positive" the response to the computers has been. 
RN-PA, RN
626 Posts
I've started warning local friends and family NOT to get sick and need hospitalization in the next few months of OUR learning curve...
And NOW, back to
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