Ive just about had it. Rant, and I never rant.

TheMoonisMyLantern, ADN, LPN, RN · Jul 11, 2011

You're absolutely right, it seems as though administrators/executives have a true talent at taking something as simple as charting nursing care and complicate the hell out of it. It's inefficient and a flat out waste of time for us to have to document one simple piece of data multiple times in multiple places, but sadly we don't make the rules.

As I look at continuing my education I seriously question my future in nursing. Sadly, I've realized I have passion for what nursing SHOULD be not the "customer is always right" manic masquerade that nursing has turned into.

Sirapples · Jul 11, 2011

I think down the road Ill look into teaching. I know I will be doing tons of papers, but I think Ill actually enjoy that.

I dont really look foward to seeing what nursing will be in 5 more years. Computers were susposed to make our life easier in medicine. It certainly has not. And this is coming from a computer geek.

2011nursetobe · Jul 11, 2011

My suggestion for you is to research and possibly find a job in nursing informatics. You have a computer background plus a nursing background. We need more people like you that recognize a problem and have the means and the brains to fix it.

CaLLaCoDe, BSN, RN · Jul 11, 2011

i am finding more and more as time goes on, we have more and more charting added on to us... expectations that far exceed reality when it comes to charting.. especially in the presence where no overtime is allowed.
i am finding that i have to rush true nursing care like a bed bath, or repositioning a patient because of the amount of charting.

wow, i couldn't have stated this any better!

i wonder how the lawyers handle malpractice suits, all that charting, all those spread sheets with duplicate charting, reams of paper. "you charted that you did this on form b, however we do note that you did not remember to check box a on form a!-- did you actually do the task?"

old charting was so simple, you do your assessment and chart it, then anything comes up chart it, bang -- done! it's all on one page for the most part, no multiple multiple forms to plow through...agh! the good old days! also you could easily compare the assessments several days prior if needed, easily. course picking up the papers that fell out of a loose binder was hell on this earth, but i'm sure a better charting system via the computer without the bells and whistles could be created.

caliotter3 · Jul 11, 2011

Also think you should look at nursing informatics as a possible career change. Might be just what you need.

beeble · Jul 11, 2011

I agree. The constant changes to charting are definatly not made by a bedside nurse. For example, to chart a Heparin gtt, we have to chart each hour, date, type in the rate, time, 'infusing', ect. for each entry/hour. That's a lot of clicks for one hour. Multiply that by 12. Multiply that for each gtt. Then each med. then 6 patients. Then the flowsheets. the required pain note for EVERY pain med you give. Nuts.

CaregiverGrace · Jul 11, 2011

Not to be devil's advocate here, but why would you suggest nursing informatics as a career choice for someone that simply wants to do more "true nursing care"? Being frustrated by computers because they take you away from the bedside is certainly not a good reason to commit more time to computers, away from the bedside. I agree that the computerization of nursing needs smart and talented professionals, but if someone has a serious dislike for the documentation aspects of nursing, going into that specifically seems like a bad choice.

Ruthfarmer · Jul 11, 2011

Brother, I feel your pain and your frustration. I finished nursing school at 42 years of age. I have a bachelor degree in journalism and a master of education degree. Before becoming a nurse I had worked as a handicapped preschool teacher/coordinator and program coordinator for the dually diagnosed mentally ill/mentally retarded. I also worked as a state medical malpractice investigator. Having been around the block, I knew that as a new nurse, there was an awful lot that I didn't know and that I had so much to learn.

Little did I know that once on the job, I would have a lot to teach other medical professionals. One thing in particular was pointing out the tremendous potential catastrophe one very large facility's computer charting was creating. For each of the body systems assessment fields, there were two or three data sets to choose from, and nurses were encouraged to select a data set and discouraged from "entering free text." Routinely three elements of a data set might be accurate but one or two elements might be inaccurate. This occurred frequently where the information on cardio and pulmonary systems assessments were charted and some of the data sets overlapped, but were contradictory.

More often than not, I found it necessary to "free text" most of the assessments fields in order to document an accurate assessment. My preceptor (a very capable young lady with 6 years experience) was horrified by the length of time it was taking me ( the silvering haired recent nurse graduate) to chart. She called me down for being "too meticulous" with my charting. I showed her the problems on the system with the conflicting data sets. She blinked several times and said, "So, what's your point?"

I pulled up a chart she had worked on and showed her how the data sets she had selected for the cardio and pulmonary assessment fields contradicted each other. I showed her how all but one element of each field was accurate. She said, "So, it doesn't really matter."

I told her that she wouldn't feel that way if it was ever brought to her attention that she was providing inaccurate data for the patient's chart. I also explained that if she ever was called to deposition or to testify in court about her charting on a med mal case, she would be in a mell of a hess trying to explain why her charting had inaccurate elements in the assessment fields. I explained what it's like to see people squirm under sworn oath when it is suggested that perhaps all of their charting is suspect and not trustworthy. Sadly, I don't think she ever got the point.

I did not stay at that facility very long because there were so many aspects of patient care and safety that were being routinely compromised. (I did make certain that I shared my concerns about the medical records with the IT folks before I left.)

There were so very many very young nurses with five or six years experience, all at that facility. They lacked the life experience and work experience to see these issues as the serious disregard for patient safety and well being that they are. This is not intended to slight young adults and their nursing abilities in any way. It's just to say that when anyone is exposed to only one way or one protocol and it's all that they know, they may not realize that what they are doing is possibly incorrect, unsafe, or a breach in the standard of care. They can be jeopardizing their licenses and not even know it.

I have also seen facilities with systems where you had to use separate computer programs to enter doctor's orders, CBG's, dietary requirements, and consult requests. None of the programs communicated with each other. What a huge drain of time, energy, and effort. Entirely too much time spent on "charting" leaving inadequate time for best practice nursing care to be implemented.

karmyk · Jul 11, 2011

My suggestion for you is to research and possibly find a job in nursing informatics.

Someone needs to explain this "nursing informatics" stuff to me because the more I'm exposed to it in the workplace, the more silly it seems... I heard, as far as IT at my hospital goes, a lot of the shots are being called by nurses who specialize in this "nursing informatics" stuff... what in the world are they teaching those people?! It almost seems like they have no idea what they're doing. This is coming from someone who used to manage/run (and do the systems design for) a network that supported 800+ users in her previous life. There are too many redundancies and too many complicated pieces to our charting software at work... and on top of that, the network is so inefficiently run that staff wastes too much precious time (because time is very, very, VERY precious in nursing) troubleshooting slow computers or trying to figure out how to navigate their way through the system (or help registry/travelers/float staff navigate their way through it).

noreenl · Jul 11, 2011

I disagree Grace Thats the perfect person because as a bedside nurse t hat person would know what we need and as a "computer geek" would know how to cut out all the extra copies of the same forms, in a different order, for a different department, or whatever cockamamie system these so called professionals are coming up with!:throcomp:

2011nursetobe · Jul 11, 2011

I disagree Grace Thats the perfect person because as a bedside nurse t hat person would know what we need and as a "computer geek" would know how to cut out all the extra copies of the same forms, in a different order, for a different department, or whatever cockamamie system these so called professionals are coming up with!:throcomp:

I agree...there's no better person to tweak programs and forms than one who #1. Is a bedside nurse #2. Has computer experience and #3. Is FED UP WITH THE CURRENT SYSTEM. Nursing informatics is using a nurse, who knows the system and the way things work, to have a say-so in the way things SHOULD be instead of some guy who has never set foot in a hospital coming up with a charting program. It is becoming more and more popular because FINALLY they are realizing that "hey, maybe the bedside nurses DO know best, and can help us implement better ways of computerized charting..." DUHHHH!

Not saying that the OP should completely ditch bedside nursing, which he loves...but his job satisfaction will be a whole lot higher if he knows he is making a difference for other nurses...AND himself in the future, instead of being stuck in a rut. Perhaps he could even get a part time position at his hospital as an informaticist, and work as a bedside nurse trialing his programs and coming up with new ideas. And can't forget to mention that nurse informaticists make GREAT money....