Electronic documentation has stolen the human touch from nursing.

[Been there,done that]

There is always a COMPUTER between me and my patient. We are required to scan meds to patient bracelets, enter admission and assessment date into the COMPUTER , text doctors and other departments from the COMPUTER.

I am looking @ the almighty COMPUTER much more than my patient. A major facility I worked for mandated that during the lengthy admission documentation, nurses ASK the patient if it was all right if they looked at the COMPUTER during the process!

They were, of course , aware that we must look at the COMPUTER more than the patient. The solution was to ask the patient for permission??? I feel typing is more valued than any people/ assessment skills I may have developed over the years. Data entry is the name of the game now.

I would so much prefer touching my patients than that damn COMPUTER!

[Roy Fokker, BSN, RN]

If it wasn't computer, it would be a paper that you are looking more than the patient.

Yep, I agree.

But those babies don't have 20-80 years of history to record every time they are admitted. You would easily spend that much time on EACH patient with the admission and charting on adults.

I guess it depends on which system you use. I can knock off a new admit in under 30 minutes, including history. And the plus point is that the next time they show up, I just have to append to their existing history and not create one from scratch.

*Roy interviewing for his current job*

Boss: "We have complete computerized charting, including all physician orders..."

Roy: "Awesome! That's all I need to know. When can I start?!"

Computerised charting, especially the system we use in our ED was a HUGE selling point to me before I signed up.

No more chasing down charts after interns and residents and consultants take it and never put it back where it belongs, wondering where some missing pages went, did that doctor put in new orders or not? What the hell does this say can anyone read this handwriting? No more running out of paper, running out of order sheets, running out of labels, running out of ink. "Have old records sent from medical records" is a thing of the past. No more "Nurse where are the vitals/lab results/x-rays?" - it's all there in one place where anyone on the healthcare team can look at 'em. Pt. Hgb is 9 and EKG says 'septal infarct'?? 2 clicks later and you're in their EMR and see that over the past 6 years and 14 visits, the pt. tends to run at a baseline Hgb of 9-10 and that septal infarct was from an MI 4 years ago (you can compare the EKG images too!) - how long would this have taken with paper-charting and "medical records"? It even helps with the differential: Does the patient have a pneumonia, lung mass, infiltrates or CHF - compare the old CXR with the new and voila!

Not to mention if you're using good software, you can cut down 'repeat charting' with the use of macros. From inserting IVs to charting codes, computers help make it way faster. Clicking is faster than typing anyday of the week - plus, my hands/fingers aren't sore anymore from all that writing. Records are more legible (and thus more useful!)

I'd rather stare at a computer screen than at a paper chart thankyouverymuch!

cheers,

[LuxCalidaNP]

This is why I try to do most of my charting AFTER i'm done with my patients (clinic setting). The risk of forgetting one tiny detail of wound care while I chart is smaller than the risk of missing something BIG because I'm not actually present with the pt.

[DSkelton711]

Pretty soon all we will have to do is scan the chip in the back of the patients skull and tada! The robot nurse will come beeping down the hallway. Only partly kidding:rolleyes:

[babyNP., APRN]

I can see that as being a plus in your setting. But those babies don't have 20-80 years of history to record every time they are admitted. You would easily spend that much time on EACH patient with the admission and charting on adults.

Don't the histories carry over if they've been re-admitted? In any case, only doctors write H&Ps, not nurses at my facility.

The nurses who worked on my adult med-surg floor in another facility (I was a tech) said they loved computer charting there as well, so it sounds like your facility doesn't have a good system.

Certainly I've hated at agency hospitals how you can't figure out doctor orders (nor could pharmacy--and they sent up the wrong antibiotic!) or worrying about someone grabbing the chart before you're done! Plus writing stuff out takes such a long time compared to typing...

Seriously, the death of papers cannot come soon enough! It's bad enough when we have downtime!

[babyNP., APRN]

believe it or not, paper documentation takes less time. especially for those who grew up before computers and never learned to type. dh keeps switching jobs to avoid computer charting -- i hope we can retire before it catches up to him!

it actually takes me longer to do paper charting, even at my own facility. i suppose some of the blame is that i'm left-handed and have to deal with trying not to smudge the ink and trying to figure out all the little boxes since my hand is covering them since the paper charting i've done is left to right instead of of right to left. you have to be so careful not to make a mistake and it can get messy so quickly. not to mention trying to read other people's handwriting or numbers when trying to add up i&os...

learning how to type and use a computer is such an invaluable skill these days--many local libraries offer lessons for patrons (although most people looking at this forum know how to use a computer i guess ). i don't know what i would do without typing skills in today's world...

in the back of my mind i do wonder if in 40 years i will be one of those complaining about the newest gadgets in nursing full circle i suppose?

[tntrn, ASN, RN]

Don't the histories carry over if they've been re-admitted? In any case, only doctors write H&Ps, not nurses at my facility.QUOTE]

The docs write the H & P's, but our admission forms include questions like this: do you now or have you ever had (followed by about 25 problems.) Then there is a form that says, have you or any close relatives ever had: followed by 15 problems. If a relative has had it, then you have to chart who it was.

Some questions are repeated on different pages, but the answers do not populate across screens.

It's the poorest excuse for a time saver I've ever seen.

[cogath]

I work at a facility that has computers in every room. The computer system is fast and very easy. It uses flow sheets a lot of Microsoft Excel. You just type "N" for WNL for each assessment area.

I also work at a facility that has 2 computers for 25 patients. The program is slow and requires we used a "stylus" to select buttons on the screen. A lot of the charting is inane and a waste of time. You have to enter each time, data for the selected section, for every action you take with a patient (i.e they had a BM at 1530 -- then you have to back track, click the other tab, and type that this BM was incontinent at 1530)

[tntrn, ASN, RN]

Oh, and I forgot, you have to type in your password for just about every single entry you make. That takes a lot of time.

[Roy Fokker, BSN, RN]

tntrn - sounds like the problem isn't computerised charting but PPP (**** Poor Programming)

We need to get you guys a better charting system

cheers,

[tntrn, ASN, RN]

tntrn - sounds like the problem isn't computerised charting but PPP (**** Poor Programming)

We need to get you guys a better charting system

cheers,

Without a doubt. But luckily, I am in this for about another 18 months and then it's retirement time for me! I think I'll start counting the days!

[tntrn, ASN, RN]

I should add that I am not one of the "older" nurses who had to learn to type or be introduced to computers.

We each have our desktops (and one in the shop), we each have our laptops (and the DH has an iPad2. I learned to type when it wasn't called keyboarding, but typing, and at one point was timed at over 70 wpm on an actual typewriter.

So Roy, you are correct....the program sucks. But I've said that all along.:)

[RhondaIndyRN]

I totally agree that electronic documentation sure takes away from my patient care. My hospital corportation implemented a new system this past February. If I could chart on a paper flow sheet again, I'd think I was in heaven. I am very computer literate and made a point of learning how to use them when my kids started learning about them in school. I too took "typing" in high school and had to teach myself keyboarding.

In ICU, we have pc's in every room and they are mounted on movable "arms." I try to position my pc so I can be looking at my patient and not have my back to them. I think this computer charting can have a tendency to make nurses look rude.

Rhonda