Joint commission and their ridiculous mandates

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I am so sick of joint commission and their ridiculous mandates on charting. They sit in some office somewhere and I am sure they have never worked in ICU and mandate what we need to chart. They say its best for the pt but in reality it actually takes away from pt care. Most nurses do what they is best for the pt and lie about what they chart. All the nurses are so afraid of getting in trouble for not charting hourly rass, starting a drip per protocol,etc that they do what is best for the pt and just lie to make the chart look good per the damn protocol. Most of us have been doing this for years and will do what is best for the pt. But now we have to lie and make it look good. Besides this it takes away from pt care to have to chart all these hourly rass if a pt is on propofol or versed. The charting requirements are taking away from pt care. Its all ********. Joint commission has nothing better to do than sit in some office and write a bunch of crap for us to do that in no way benefits the pt. Its quite obvious that they are completely ignorant when it comes to actual hand on care. More and more time in front of a computer is less time to spend with pt. Besides that we lie on the charting and do what is actually best for the pt. What joint commission requires is completely, total ********. They say its for pt safety but its just to give them something to inspect to protect their jobs. They have nothing better to do.

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Specializes in Infection Control, Med/Surg, LTC.

It is all done to justify their own existence and keep those survey fees rolling in. I could never figure out why we would actually pay to be made miserable.

They would set a standard and we would work like slaves to satisfy it, they would inspect and determine that yes, you met the standard but we don't agree on the way you chose to do it. Well, my feeling was 'then just outline the steps you want us to use and we'll do it', but don't be critical of the method that works for us if the outcome is what you wanted.

Then you would work like slaves again to come up with a method they would approve of and on the next survey they would totally ignore the entire issue!

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Specializes in ICU.

Bingo. My hospital no longer uses them, but get state certification instead. Our DON said why do we need to keep paying them to tell us everything we do is wrong.

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Specializes in Infection Control, Med/Surg, LTC.

Also, the state comes in for free! And as long as you are state certified you continue to get paid by Medicare/Medicaid. JCAHO is just a 'perceived' status symbol.

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Specializes in Critical care.

My facility went to DNV 2 years ago...way more gooderer:yes:

Their focus is on continual improvement, and they add nothing above and beyond what CMS mandates, unlike TJC. All with a more collegial approach.

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I've always been amazed at JCAHO. They come in every year, find something (usually paperwork and paperwork-related processes) that they hate, and tell us how to fix it or else. We fix it, even rewrite policies (an arduous process in itself) and they are happy. The following year they come in and tell us that the same processes we implemented are wrong.

It's really a system of people trying to justify their jobs. If they don't find something "wrong," then no one needs them.

Therefore, they will always find something "wrong."

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Specializes in EP/Cath Lab, E.R. I.C.U, and IVR.

My biggest pet peave regarding JCAHO is most everytime I see them going through paperwork, looking in shelves and cabinets, etc. I have yet to see a representative come any where except the OR and actually watch patient care because that is what it is all about. "Lets make sure that this cabinet with oral contrast is locked up at all times, even thought we did not care about it two years ago."

I really hope they have an off switch because I would hate to be married to someone whos main job was to hypercritical of everything around them.

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Specializes in Care Coordination, MDS, med-surg, Peds.

ok, maybe YOU lie all the time in your charting But I don't and Please, don't assume that I do, or that other nurses do. This one thing in your OP ticked me off, so will bow out for now. But please, continue to lie in your charting and see where that gets ya, Babe!

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Specializes in Emergency room, Neurosurgery ICU.
ok, maybe YOU lie all the time in your charting But I don't and Please, don't assume that I do, or that other nurses do. This one thing in your OP ticked me off, so will bow out for now. But please, continue to lie in your charting and see where that gets ya, Babe!

this! ^^^

and this:

RASS scores are important... they let you know how well that propofol/versed drip is working and justify your titration of the same. They in no way ever took me away from patient care. But then, I easily learned how to prioritize and manage time with the patient and time spent charting.

Protocols are in place for a reason, they are usually evidence based practice. I wouldn't want the nurse who doesn't follow protocol for those pesky drips, etc to take care of me or my loved ones. Patient safety is the one of reasons we are nurses.

and shame on you for falsifying charting. (CYA does not mean "make crap up")

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Ok,you obviously don't take care of critical care patients that requires split second decisions. So you actually go by a protocol for titrating levophed instead of looking at the patient and doing what is best. Wow! You are obviously a new nurse, a manager, or an ass kisser. If you took care of the kind of patients that I do you would absolutely agree that all that charting on a rass q hour and making sure you go by the stupid protocol for titrating levophed instead of doing what you know is best for saving the pts life is all a bunch of crap. I have been a critical care nurse for 30 years. I am in charge of a large ICU. The charting joint commission requires takes away from patient care and is ridiculous. They have obviously never worked in icu. Let nurses do what they do best. Take good care of the patient. All that charting of a rass and following protocols is crazy because when my pt is crashing I will titrate drips based on what I know works. My priority is the patient. So I will titrate the drips to save my patient and chart whatever the hell I I have to to pass the damn audits.

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And by the way all the critical care physicians I work with totally agree and trust the nurses judgement. They also think its a bunch of crap.

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Specializes in SICU, trauma, neuro.

I'm more irritated when they interrupt me to ask P&P questions when I'm in the middle of said critical patient care, I agree that some of their stuff is ridiculous, and I'm tempted to ask, "Et tu, Brute?" when an RN-surveryor introduces herself. :cheeky:

I'm not sure what's so difficult about hourly RASS's, though? And I DO take care of very critical patients; I work in a level 1 trauma/neuro/SICU. It takes a fraction of a second to type -1, 0, etc. In my ICU, if someone is on hypo- or normothermia, we have to manually enter their shiver level, target temp, water bath temp, q 1 hr. For hypothermia where we have to enter 2 temp sources, one crosses over from the monitor but we have to manually enter the 2nd one q 1 hr. If someone is on neuromuscular blockers we have to enter their BIS and To4 manually q 1 hr. Neuro pts, we enter their neuro exam q 1-2 hrs...parts of it we can C&P before validating it, but other parts of it we have to manually enter. Ummm...CO monitor data doesn't cross over, CRRT data doesn't cross over. Basically, vital signs on the monitor are all that crosses over. Entering a RASS is about the quickest thing to document.

And no, I don't falsify legal documents.

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