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:
Bless you and good luck! I hope you're feeling better soon. It makes me sad that those who treat the sick are being made ill by their jobs. Gauge-I know what you mean. The power that is, needs to get his rump out of the office and come talk to the staff. Also, our unit rep feels it is easy to use (she helped build our screens) so she sees no need to change things. She is a a very capable and very nice person, but somewhat inflexible. For example, we asked for a re-assessment screen for our c/section recovery pt's rather than sorting through this and that on the inital assessment screens when we recheck q 15 min, but she says it is not needed. You may only recover 1-2 sections per month or even less, so it is easy to forget where to document this and that. It is little things that can really bog you down and create unnecessary stress, esp. in the face of other major stuff going on. Sometimes, just that little bit will send you over the top. RN-PA please put yourself first and do what you need to do to de-stress.
New computer systems are no picnic for the rest of the hospital departments either. We have various forms called Protouch, Invision, and now LCR (Lifetime Clinical Record) which are somehow connected to the lab Sunquest (Mysis) system. As a blood banker, I get desperate calls constantly from the floor staff regarding blood orders and blood gas results. Well....I cant help them because I have NEVER seen the other systems screens, so I dont know what they are talking about.....
It has gotten to a point that I tell confused folks to call another unit who has a knowledgeable secretary, or else call the nurse supervisor who is on call. Sounds like delay of care to me......
As one who hates electronic doc immensely, I feel your pain. What you need to do is call the info systems backup in the hospital immediately when some computer snafu delays pt care. The more that guy/gal is pestered to work these bugs out the faster it will happen. Remember to tell them you need this fixed because it is interfering with pt care/customer service!!!!
I would not worry about appearing overwrought at work. Administration needs to see it or they just think we can handle everything they throw at us...I know its hard for us to admit we can't always do it all. Even nurses have limits.
My PCU unit has just gone to EMAR. They must first take their meds out of accudose and place them on a scancart/computer on wheels. Then they must roll this huge contraption into patient rooms and scan their armband to give every med. The system is full of bugs, too time consuming, patients are complaining about the noise and inconvenience (esp at 2 am) and the nurses are all on OT every day. But...it is not the nurses' fault. I don't know how they get ANY patient care done on this unit!!! I am NOT looking forward to this new system when it comes to my ICU.
I totally agree with you the EMAR and computer documentation is much more time consuming than our paper flowcharts ever were in critical care. This was not done for the convenience of anybody other than the corporation. Typing in vitals q 15 minutes are ridiculous, and our charting system is too tedious. Administration is nonresponsive. Doctors and patients complain 'the nurses have their noses in the computer all the time'. Well yeah!!!Wonder why?? Duhh!!
I have adopted 2 new saying "I only have 2 speeds and if you don't like this one ya sure aren't gonna like the other." and "I don't make the decisions around here, so complain to somebody who does please." I then provide the administrator's name. Yup, I may lose my job soon...but I'm sick of this game where nobody cares how overwrought the nurses are. Maybe it's time I retire anyway....
Sorry so long...as I can totally relate to the frustration as most here can. I wanted to tell you you aren't alone. Take care of yourself. :kiss
Man that stinks - we are in the process of miving our facility to e-mar as well. I agree that there are definately snafus but overall the nurses seem pretty pleased with it once they have used it for about two weeks.
My biggest complaint is the same as yours - carts are HUGE and noisy and hard to get into the patients rooms. We have blood glucose monitors that scan things and file them in the computer - WHY for heavens sake can someone not make a little handheld machine that does that with medications and patient armbands???? Actually - I do know that they DO make such machines...and I know that they are (or can be) compatible with meditech and e-mar....(which just frustrates ME all the more!)
but guess what? yup - too expensive.
For those of you who didn't know it HCA OWNS meditech so if you have anything else and you work at an HCA facility, dont bet that what you have will be upgraded or improved....nope - just changed to meditech when it gets too old.
The real crux of the information technology issue and nursing is this - we are TWENTY years behind in the medical and nursing side technology wise. Health care systems and facilities failed to keep up with new technologies and didnt invest money in computer systems and advances - but then how could they when they were losing money faster than they could make it?
Payors are now requiring certain things to be a certain way in terms of how records are kept, entered and transmitted for billing or the hospitals dont get paid, thats why the sudden jump on the bandwagon for computerized documentation. It's just going to take 20 years to make up the 20 we lost unless bedside nurses get real involved and very vocal about it. It isn't going to go away but if we want to impact how technology will affect nursing now and in the future, we can't just sit around and complain. I am a techno geek in my other life - have done some programming and worked on some fortune 500 web sites in the past couple years. I love technology and I feel like my hands are tied at times for the lack of up to date and current technology at the bedside. Just know that what we have now is NOT up to date and current!!!! Other industries would be so ineffecient on the kind of technology healthcare has that it would put them out of business. Cheaper is not always better when it comes to time and motion efficiency.
As for charting Q15 vitals - get a monitor interface! Bug em till they do...let the monitor do the work for you. Or just print a strip every hour with the Q 15's on it and tape it to the frequent VS record - make the technology you do have work for you instead of letting it make you work for it.
I would not worry about appearing overwrought at work. Administration needs to see it or they just think we can handle everything they throw at us...I know its hard for us to admit we can't always do it all. Even nurses have limits.
I totally agree with you the EMAR and computer documentation is much more time consuming than our paper flowcharts ever were in critical care. This was not done for the convenience of anybody other than the corporation. Typing in vitals q 15 minutes are ridiculous, and our charting system is too tedious. Administration is nonresponsive. Doctors and patients complain 'the nurses have their noses in the computer all the time'. Well yeah!!!Wonder why?? Duhh!!
I have adopted 2 new saying "I only have 2 speeds and if you don't like this one ya sure aren't gonna like the other." and "I don't make the decisions around here, so complain to somebody who does please." I then provide the administrator's name. Yup, I may lose my job soon...but I'm sick of this game where nobody cares how overwrought the nurses are. Maybe it's time I retire anyway....
Sorry so long...as I can totally relate to the frustration as most here can. I wanted to tell you you aren't alone. Take care of yourself. :kiss
Thanks, mattsmom and to others for input, encouragement, and suggestions. We just had our monthly staff meting today and four of us showed up. I felt bad for our clinical manager because she heard all of our frustration and negativity. They can't get the extra staff in to help as we learn the computers-- even with bonuses-- [ HEY ADMINISTRATION! IT'S THE HOLIDAYS! PEOPLE ARE BUSY ENOUGH AND DON'T WANT TO PICK UP MORE TIME!!! ] Our hospital was actually on Divert today for a while, and once it was lifted, the ambulances poured in. I walked past the ED and was just thankful I only go in tomorrow evening... :stone
One of the nurses at the meeting brought up nearly what you said: "I would not worry about appearing overwrought at work. Administration needs to see it or they just think we can handle everything they throw at us...I know its hard for us to admit we can't always do it all. Even nurses have limits." They think we will always roll over and be compliant and suck it up. Well, they've got some surprises coming, because this is one big unhappy group of nurses and PCT's.
Maybe this will finally get them to listen to us if the outcry is loud enough. I also will be adopting your sayings: "I only have 2 speeds and if you don't like this one ya sure aren't gonna like the other." and "I don't make the decisions around here, so complain to somebody who does please." I then provide the administrator's name.
:stone And yet all the hospital newsletters and other propaganda spins how "positive" the response to the computers has been. 
imenid37
1,804 Posts
Bless you and good luck! I hope you're feeling better soon. It makes me sad that those who treat the sick are being made ill by their jobs. Gauge-I know what you mean. The power that is, needs to get his rump out of the office and come talk to the staff. Also, our unit rep feels it is easy to use (she helped build our screens) so she sees no need to change things. She is a a very capable and very nice person, but somewhat inflexible. For example, we asked for a re-assessment screen for our c/section recovery pt's rather than sorting through this and that on the inital assessment screens when we recheck q 15 min, but she says it is not needed. You may only recover 1-2 sections per month or even less, so it is easy to forget where to document this and that. It is little things that can really bog you down and create unnecessary stress, esp. in the face of other major stuff going on. Sometimes, just that little bit will send you over the top. RN-PA please put yourself first and do what you need to do to de-stress.