Last week, handed a booklet detailing my job expections; I work 7am to 7.30pm on a surgical/tele floor.
7am meeting huddle, 5 -10 mins, mostly on what more we need to do; then get assignment, paperwork, do walking rounds, check all lines, answer lights, be on top of meds, phone calls, escort any pt with a chest tube, heparin drip. etc, to various tests, chart your assessments on 5-6 pts, mostly post op, within two hours.
We have CPOE, which means the docs enter their own orders, except they enter nursing comunictation orders, which mean i have to enter them. Check every pt hourly and sign a sheet. We take high dependency type pts, despite being med/surg floor.
The Unit secretary, and LPNs, can no longer imput orders, check orders do admits, give narcotics., and all post op pts must have a full history and admit done on arrival. Discharges must be done within 60 mins. Meanwhile Im supposed to give pts the best experience ebver by sitting with them, making eye contact etc.
Is this normal now? Just wondering what other facilities do. Been a nurse for 20+ years, and I can't handle it.
"We are sorry we didn't' meet your expectations, and we are trying to do better, please take this token for a free meal in our cafeteria as our apology".
that is Medicare making the rules.. they are no longer going to pay for passive care, they are going to be an active payer. Meaning they won't pay if the scores are low
I hear people repeating this and it was starting to drive me crazy not knowing for sure what's gong on so..I answered my own question and I am surprised to find out that while I was taught that HCAHPS does not affect insurance reimbursement, that it won't be that way for too much longer.
It used to be pay-for-reporting. Starting FY2013, Medicare and Medicaid under the Patient Protection and Affordable Care Act will in part be reimbursing on a pay-for-performance format which will be partially drawn from HCAPHS scores from FY2012. These payments will be funded by reductions in DRGs (diagnosis related group system)
Minor side note: While researching, something interesting came up- HCAHPS is careful to point out that it is NOT a satisfaction survey as they do not ask patients to rate their "satisfaction". It is supposed to subjectively rate the consistency of specific aspects of care (never, sometimes, always) like doctor communication, etc.
Specializes in vascular, med surg, home health , rehab,.
Just wanted to say thanks for all who responded. In answer to a few questions, we do have a union, poor support from the staff 35%. Non nursing, but great for sorting out write ups for nonsense. But hard to get a nursing perspective across and our CNO seems to hate nurses. We had a discharge nurse for a few weeks, it helped, there were issues with the fact they are rushed and don't know the pts, so when I went to give the discharge stuff all sorts of things would pop up, such as "when do I start my coumadin?", the MD hadn't addressed, so you look like a fool. But that stopped after a few weeks. I guess too expensive. Have reached the conclusion, its time to find a new career; based on feedback here, well a new job would'nt fix the problem. We used to be nurses, treated with some degree of respect, use our brains,our skills, have some say in the care of the pts we knew; now were just chimpanzees. Assaults on all fronts; care worse and worse. After all these years, have to face up to the fact, time to find a new career, and note to self don't get old, or sick and be at the mercy of this current system.
i am a brand new nurse and, honestly, this is all i have known. I actually chose my hospital after graduation because of the small pt load of only 5-6. While training, we had to enter every single order ourselves, not having to do so is only a recent change and i still find myself picking up charts and noting orders even though we have a ward clerk. I can't imagine the difficulties you must be facing in having to change your entire career's routine, but as a nurse, I have to assume you are very adaptable. I believe that you can adjust and I hope you succeed for the sake of us "newbies". We need experience around us!
Specializes in vascular, med surg, home health , rehab,.
Thats the problem; they only want staff who have never known anything else, and when I tell you, there is so much more to nursing than what we are doing right now, you probably would wonder what. We used to be able to assess and treat pts;now I find myself apologising to pts, ocs, pts caregivers, all day long> because Im not functioning as a nurse; Im a secretary, a doc, a pharmacist, it's triage and putting out fires. I see new nurses and I wonder how in the hell they do it; Thank you for your post, you obviously care about your pts. I wish you luck in your career. And that you don't put up with this nonsense we have to deal with. Trouble with nurses we just take the abuse.
We had a discharge nurse for a few weeks, it helped, there were issues with the fact they are rushed and don't know the pts, so when I went to give the discharge stuff all sorts of things would pop up, such as "when do I start my coumadin?", the MD hadn't addressed, so you look like a fool. But that stopped after a few weeks.
To be honest, I don't even believe in my own suggestion because I encountered the same difficulties with the discharge nurse thing. How can you discharge a patient whom you know nothing about? The position seems to imply that nursing can be automated or patients are all the same. We need all the unnecessary work cut out of our duties so we can focus on the important things like doing a proper discharge.
Just wanted to say thanks for all who responded. In answer to a few questions, we do have a union, poor support from the staff 35%. Non nursing, but great for sorting out write ups for nonsense. But hard to get a nursing perspective across and our CNO seems to hate nurses. We had a discharge nurse for a few weeks, it helped, there were issues with the fact they are rushed and don't know the pts, so when I went to give the discharge stuff all sorts of things would pop up, such as "when do I start my coumadin?", the MD hadn't addressed, so you look like a fool. But that stopped after a few weeks. I guess too expensive. Have reached the conclusion, its time to find a new career; based on feedback here, well a new job would'nt fix the problem. We used to be nurses, treated with some degree of respect, use our brains,our skills, have some say in the care of the pts we knew; now were just chimpanzees. Assaults on all fronts; care worse and worse. After all these years, have to face up to the fact, time to find a new career, and note to self don't get old, or sick and be at the mercy of this current system.
I'm thinking of going back to one of my old jobs: international art thief.
Or I could just pick up beer cans on the side of the road.
Vespertinas
652 Posts
I don't know whether to laugh or cry