Moving from narrative to focus charting

4fifteen · Mar 23, 2008

First off -- if this isn't the right forum for this topic, I'm sorry. I've no idea where to put it.

Anyway. Our hospital has been on using the narrative method for charting for, well, forever and now they want to change it to the focus (DAR) method. Aside from not liking change to something you've been used to doing for years, focus charting is so foreign to us; I've only heard of one hospital in this country using that method.

What I'd like to know is how this works for you guys. I mean, I know what DAR is and have an idea how it's done; what I mean is how it affects the overall workload. We aren't utilizing computer charting (and I doubt we'll ever be). Also, we use the functional method of giving nursing care, so in our unit where we are full with 16 patients (others have 20-21) there are only two nurses -- one is in charge of giving meds and watching the IVs, the other works on admitting & discharging patients, notifying doctors, carrying out orders, making sure labs and procedures are done, charting (usually the senior nurse) -- and one NA.

So now I'm wondering -- is it doable to use focus charting with this set up? When we're really swamped (doctors making rounds simultaneously, then patients needing something right after, and you still have to carry out doctors' orders when another doctor comes up or a new patient is to be admitted - you can barely squeeze in time to pee much more eat) we have sometimes just cram everything in our heads then chart everything at the end of the shift after endorsement. Obviously, we end up charting something we did hours after the action and then I have to do some guesstimates for time (add to that thinking of appropriate terms and words) and yes, we stay overtime for an hour or even more just to finish the charts and we don't get paid for that.

Personally, I'm just not too keen on the probability of having to go on overtime much longer than we already are doing which is why I'm rather apprehensive on this.

Also just wanted to ask -- I've read about 'checklists that accompany your charting'. Er, checklists on what?