Fed UP IN MISSOURI!

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Specializes in critical care.

I have never posted a new topic and am hoping for responses regarding: State Inspections/JCAHO/Managers. I work in St. Louis in one of the larger hospitals. JCAHO is going to be inspecting and the entire managerial staff is grilling us re: Questions Joint may ask? Auditing Charts like mad, POLICIES, pt safety etc etc etc. I AM SICK OF IT! They are having us/secretaries etc police the doctors about signing off verbals/telephone orders, and all the BS that goes along with accreditation. Yesterday our manager was freaking out about who was covering a patient while his primary nurse was taking a patient for testing. Now this man was stable, 24 hours post-extubation, full-code, hemodynamically stable. I work in the ICU and we do not have PCA's, NA's. I really had no idea who was covering, but told her that I would cover him. She continued to question everyone about him because his wife had wanted an update on his condition (she had phoned, the secretary told her to call back because his nurse was off the floor with another patient). We were told that if covering another patient, we HAD to accept phone calls re: that patient. That it was unacceptable to put a family member off. Now it turned out that the nurse covering his care was in an isolation room and unavailable. Apparently that did not matter. In effect the impression we all had was we should have DETAILED info re: ALL patients on the floor not just our own. I was fuming! HOW MUCH ARE WE SUPPOSED TO BE RESPONSIBLE FOR?????

The next incident happened with our nurse educator, we had just rec'd a code from the floor, (the 2nd in 10 min), as we were stabizing her, the educator came in the room and asked, "What happened to the O2 tank? Was it secured?" Now lets talk about priorities here, do we stabilize the patient? OR do we make certain that our butts are covered for JCAHO???

Now I must know: What direction is nursing going? Is our job to provide care to patients? Or to drown in RULES/Paperwork? To what extent does family dictate care? And how much verbal abuse do we need to take? Recently I was reprimanded for angering a family member. Now this man advanced upon me, was IN MY SPACE shaking his finger at me, telling me that I had a bad attitude etc. To his credit, I had, HAD A ROTTEN DAY! No break, worked from 645-2030, and yes I was fed up. But I wasn't hateful, nor was I unprofessional, I WAS short with answers, and NO I wasn't overly sympathetic to him (his failure to thrive 89 year old wife, alzheimers, 44 kg, broken hip/broken humerus etc.) I told him she needed to go to a nursing home, and he didn't like that. When he got in my face I told him to step back and to get his finger out of my face, because that was RUDE. Of course when called to the office, guess what....Yep I was wrong.

Nursing is becoming impossible to perform. It is the only profession where your break time is not given, where others can be abusive towards you, where you have to lift more than your own weight with little help. Where you constantly are put in positions of defending your CAREER. Patient directed/state mandated. Where rules are in place that set you up for failure. :twocents::twocents::banghead::banghead::banghead:

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I hear ya! I've heard many nurses say that they used to be able to spend more time with patients 6 + years ago when ratios at my hospital were much higher. The paperwork is taking us away from the patient and we have to get after the MDs to sign this and that. I get fed up having to chase the doctors down to sign medication reconciliation sheets (which they should be doing anyway). The simple solution would be to start holding doctors responsible for doing their own work... but that won't happen because it's too logical. Charting will only get worse... no wonder there is a revolving door of nurses, old and new.

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Specializes in medicine and psychiatry.

Won't even ask which hospital but I bet I can guess from over here on the east side. I have decided that Joint Commission is not my friend. It is clear that they are very aware of the problems in these hospitals yet only aggrivate the situation with their increasing demands. Nothing about care is improving. I think we should march on Washington.

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I am our unit educator and I can not stand the pressure of JCAHO. I feel sometimes that all of the steps we have put in for safety in some ways backfire. There are now so many steps and checks we must make at the bedside that we hardly have time to talk to or look at the pt. closely. This takes a huge chunk of our assesment out. Pts. don't tell us things because we must breeze in and out of the room and on to the next set of tasks. I feel terrible for the staff. I do pitch in w/ pt. care on a pretty regular basis. I do not see it getting much better unfortunately. I think it will take a revolt by informed pts. that they want more quality individualized care and more time w/ their nurses for things like education. On may occasions, I am appalled with the "hotel" atmosphere which has been created. We are not a hospitality industry. Why do we set ourselves up to do this? We cannot make everyone happy. It is not Disney or McD's. We deliver a neccessary and vital service and often tough or bad news. All of the documentation and compulsiveness make it impossible to even be polite or show genuine interest in someone as we must hurry up and move onto our next list of tasks and coupled with this service with a smile, I will make it right for you attitude, we are in a no win situation. It makes me angry and sad. If there was not so much worrying about EVERYTHING that seems to fall to nursing, it might be easier to get a response out of that pt. who is holding back info. or deal patiently withe little old husband who is getting on our nerves. Our unit has so many checklists that I am certain we will soon be inspecting the vehicle that pt. rides home in to see if the tires have enough tread and enough pressure. Sounds like a job for some mechanic, but he is too busy...the nurses will have to do it!!!. BTW, I am so sorry you had a bad day. I have so been there too, though from another angle.

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Specializes in psych,maternity, ltc, clinic.

That was one of the best things about getting out of the hospital systems...getting out from under the thumb of JCAHO. They can in no way be considered your friend . Talk about paranoia strikes deep! We'd be preping for Jcaho then have a dreadful 3-4 day visit from some Hitler in drag, all patient care stops so we can be Interagated about petty things. We'd get a report, usually fine or with some small corrections, and back to prepping for the next time they show their faces.

I am so glad to be out of that.

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Specializes in med surg, ccu, icu, nursg home, md offic.

nursing is starting to really suck. We cannot give the care we want to give because of all the paperwork.

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Specializes in Critical care, tele, Medical-Surgical.
nursing is starting to really suck. We cannot give the care we want to give because of all the paperwork.

Is it paperwork?

Or are you taking care of the computers?

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