New to nursing but arleady tired of freaking politics.

[Blackheartednurse]

Ok so when did the papework became more important than the patient himself? Was I asleep or something? Is it always have been like this that the managers put so much emphasis on papework?

Ps.I had a very complex case yesterday and all my boss cares about is freaking papework.

[GHGoonette, BSN, RN]

There's nothing wrong with keeping careful and detailed documentation; after all, it's what saves your butt if the paw-paw hits the fan. Now, if those who design the charts would stick to the KISS principle (keep it simple, stupid), we'd all get our work done quicker, our patients would have better care, and we'd probably all sleep better at night...

Computer charting sounds great, but if the program doesn't cut it, it will end up as just being more time-wasting for the poor ruddy nurse. Why administrators throw money away on expensive systems that don't contribute to efficiency boggles my mind. If you're going to go electronic, get a decent developer and do it right the first time, otherwise go back to written charts and employ a few out-of-work data capturers, who will be very grateful for the work. Probably won't cost much more than some of those programs, either.

[leslie :-D]

let's face it:

documentation serves us well when we need it to cover our hiney's.

i'm certain the same holds true from the employer's perspective...

that w/o the required paperwork/documentation, they will not be reimbursed.

therefore, it as just as important to them, as it is to us, for when we need it.

leslie

[latebloomer74, LPN]

i think it's happened in the last decade or so.

where i work now, we have to chart blood sugars (hourly because we're on insulin drips) in four different places. once on the vital sign flowsheet to explain why our insulin drip is the rate it is, once on the poc testing lab sheet so that it can be compared to the glucometers when they're downloaded. once in a separate computer program where we're documenting drugs -- so the insulin drip rate is charted twice in two different computer programs. and once on another sheet for someone who is doing a study. i've asked why the study folks couldn't just pull it out of the chart, but no. we have to make it easier for them, nevermind how it adds to the workload of the bedside nurse.

i think press-gainey had something to do with it -- all those satisfaction surveys have us documenting every time we offer the patient a drink or a bedpan. and the safety initiatives, which seem to have evolved in the past decade. there's more paperwork to fill out for each of the safety initiatives. sometimes i'm so freakin' busy filling out paperwork, there's no time to actually do the safety checks. it's a strange world.

this is somewhat off topic but ruby would you mind explaining when a insulin drip would be required? i don't recall that being covered in my lpn program at all:uhoh3:

[SHURN]

Ruby, I'm with on the insulin documentation! We have our "insulin flowsheet" we "need" to document on - any changes to the drip, hourly with the gluc reading. However, we still document the rate hourly on the computer flowsheet. Not only that, but all of the readings download to the computer too. I do still do this because it does help me keep track with everything in one place. Wouldn't it be nice if we could click the rate documented on the computer, and it would show us the reading that corresponds to that time?

The one I refuse to participate in is our "anticoagulation flowsheet." We get the PTT, then document all of our changes, etc, on a paper(similar to the insulin paper). But, big but, our computer system actually had an "anticoagulation" tab! We click it, it shows all the PTTs, then all the times of dose change and what dose, right next to it! I mean it's not like we are doing hourly labs like with an insulin gtt. Every 6 for heparin, every 4 for argatroban.

So why do we need to document on paper? Oh cause the MDs don't like looking around for it! First of all, not my problem. Second of all, I have NEVER had an MD actually note what the gtt is running at, unless there is a problem, and Im the one calling them anyways.

So now I show every RN that tells me, "oh you didn't fill out the paper" where the tab is. Guess what, it's not very highly advertised!

Ill get off my soapbox! This just really irritates me to no end, for some reason!

[SHURN]

And one more thing. As far as saving our behinds in case of a lawsuit....well the lawyers GET PAID to dig through charting and paperwork. I do write a short note for any unexpected events (not just for rhythm change or what have you),or if I call a doc and no orders were recieved(since I don't have the order to verifiy the notification) but as far as this stuff I'm talking about, it's all there and pretty obvious what happened.

ok done, I promise!

[KarmaComesAround]

In my opinion,taking care of the patient comes first and paperwork second. Both are very important because both can lead to law suits.Unfortunately, paperwork is the best proof, sometimes it can be good proof or bad proof. I am sure some paperwork can be done when you have freetime(during your shift).

Free time? What free time??