New sheriff in town

I wish we could target treatment at actual patient issues instead of scrambling to cover our 5th point of contact "in case someone sues" at all times. The overkill can be nauseating and combined with Viva's point about the "customer service" approach, it's downright ridiculous.

I would like the ability to say, "no." As in, "No, I will not call the doctor and ask him to give you Dilaudid for your sprained ankle." "No, you do not get all the pillows in the facility to yourself." "No, we will not be doing CPR on your 97 year old grandmother with terminal cancer." "No, I will not bring you a second breakfast. Just because it's a diabetic meal doesn't mean you can have as much as you want."

I suppose this fits under the "Customer Service" post of Viva's.

Brief, concise MARs, meds listed in an order that makes sense.

I'd really like an updated system so I could see, online, somewhere in the patient's profile, the "likely time" procedures would be done on a patient. I hate when a patient is NPO for breakfast and lunch, and no info to give them (unless I make a few time consuming phone calls). Even if it would be something like "patient 7 of 9 on list, likely time y:zz". We used to see the dialysis scheduled times before our hospital outsourced dialysis (now the inpatients don't get any meals or medications during dialysis).

To require parents send their kids to school ready to learn:

That means they are fed, dressed, clean and rested.

That means they are ready to learn

It's all so broken, any change would be an improvement.

First and foremost stop promoting the idea that patients are VIPs whose every wish and desire is available at the snap of their fingers or a ring of the bell.

Thinking that a pt has this right or that right, even if it means it's clearly not in their best interest or unjustly minimizes what we do or offends us in some way just so the hosp doesn't get sued. I work in a rehab/mental facility and the one think I hate is that there is a phone on each unit for the pts to use when ever they want. If they are there for rehab and to change the way they think, wouldn't it be wise to earn the privilege to use the phone instead of calling your "supplier" everyday to let them know how you're doing? I am constantly yelled at, cursed at and treated horribly. Sometimes I do tell the pt, "I am not disrespecting you; so, if you want something from me I expect the same in return" Just so tired of hospitals thinking the pt is "right" and we are to do what ever they want. Sometimes saying NO is the best thing.

KEEP CALM and RN ON.

The way employers think its okay to treat us like dirt. trying to make us work for free or get the absolute most for their money out of us by giving us double the work to do........

but what really gets me heated is when they say

"WE REALLY APPRECIATE YOU"

PolaBar said:

I'd really like an updated system so I could see, online, somewhere in the patient's profile, the "likely time" procedures would be done on a patient. I hate when a patient is NPO for breakfast and lunch, and no info to give them (unless I make a few time consuming phone calls). Even if it would be something like "patient 7 of 9 on list, likely time y:zz". We used to see the dialysis scheduled times before our hospital outsourced dialysis (now the inpatients don't get any meals or medications during dialysis).

When I was an RN working on an inpatient unit I would so totally agree with this! I now work in a procedure area (actually, my facility's OR)... Our schedule goes out the window before the first case of the day can start. We're a level I trauma center (including a burn center), and a transplant center (we have a program for hearts, lungs, kidneys, livers - all of it). Bonus points, we're a state hospital, so we get all of the state and federal inmates in our state. My point is our master schedule is fluid. Cases get moved more often than numbers called at a bingo game. We face a lot of potential delays - anything can be a delay too...

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Get ride of computer record keeping systems (EMR) . . . . it is taking time away from patient care.

Nah. For me they are faster. I can chart on a patient while a physician puts orders in, so on and so forth. I worked with paper charting and worked with EMRs. I much prefer the EMRs. Where I worked as a NA during nursing school - only critical care units (MICU, SICU, NICU, NSICU, L&D/high risk OB), one inpatient building (7 units), the cancer center and the ED were on computer charting. Everywhere else was on paper charting. As a NA that sucked so much, because I had 10 patients to chart vitals (usually q4, q6, sometimes q1-2), turns q2, I&O q4, accuchecks as frequently as q1, patient care (baths, meals, carb counts)...charts never were at the unit desk like they should be - nurses hid them and would then hide themselves so you couldn't find them. Doctors took them and hid them too...

I love the EMR - information can be put in from multiple locations - RNs, LPNs, PCA/NA, physicians, midlevels... It can be accessed from multiple locations - procedure areas can see the last time a bleeding patient had lovenox etc...