Quote from nurselearner
stick to nursing info in your notes. The social worker will add the psychosocial
Quote from earle58
you needn't write anything but relevant info r/t the nsg dx's.
s/s? meds? subject c/o? objective data of pt.
any psychosocial and history belongs w/the licsw.
try to keep it focused around the here and now, and the skilled nsg care potentially and presently required.
Wa! I'm so proud of myself managing to get both your quotes together. Almost as satisfying as managing to get my avatar to animate.
Yeah, I was told not to worry about more than a smattering of psychosocial stuff as the MSW will cover that. But its more like my response to augigi. You seldom have a patient, especially the elderly ones, who have only one diagnosis.
If your liver cancer patient also has mild COPD, severe GERD and gets splitting headaches, what do you do? I feel like I'm cutting the patient into little parts by only concentrating on the cancer, which is the real problem - but by bringing everything into it I wind up with an total body assessment a medical student would be proud of.
And, ye gads, the meds!!! Calling the pharmacy, giving info to the tech, being transfered to the pharmacist, giving all details about every med, having them re-read them to me, finding out which ones are covered - and then putting them all into the system. Starting with 'searching' through brand names, moving onto dosage and route and then finding out only liquid is dispensed - and having to cancel that and go to 'manual' and typing all the info into the spaces provided yourself just takes up hours. I mean - we have to enter every med they take - aspirin, acetaminophen, saw palmetto, melatonin - and we all know some patients have mini pharmacies in their homes.
I know many of the nurses get there very early in the A.M. and put in ten hour days but never put down for overtime as they say they'll get fired. Hells Bells to that! If I work twelve hours and don't get a lunch I expect to claim it as OT. But that still leaves other nurses who do manage to do it in the allotted eight hours. The only way I can think of doing that is to spend a minimum of time with the patient and somehow cut down on the gathered info.
Please excuse me, y'all. Just kind of thinking out loud. Work was sooo much easier when everything was on paper! Aaaaaaarrrrrrrrrggghhh
Can we please get a smiley that is tearing their hair out. I think it would be totally appropriate in many situations.