Paperless med-surg

[JBMmom, MSN, NP]

Our facility recent changed EHRs, and we're being told that soon we will not be allowed to have any papers for our patients. The previous system provided multiple sheets per patient with the orders printed out, and I found it very cumbersome to navigate. I have my own sheet and I can cover my 7-8 patients on 2 pieces of paper. The EHR has a report page that we are told we will reference during bedside report, but to me that is very difficult to synthesize into an informative report. And I use my paper as a checklist throughout the shift, to remind myself when I've checked patient #1's IV flushed, and cleared the pump volume for patient #4, done my education and care plan on everyone, etc. Are there other med-surg nurses out there that have gone totally paperless? Any tips on how to do it? I really think that some of us are just list/checkbox people and to demand that we not use them, just to save 2 pieces of paper, seems like focusing on the wrong aspects of our job. Ensuring that I'm able to do my job thoroughly and safely, even if I need some paper, doesn't seem that awful to me. I'm not resistant to change for the sake of being resistant, and I'm definitely willing to give it a shot, I could just use to tips. (Or others with experience that it did or didn't work out). Thanks!

[Sour Lemon]

We are paperless ...don't even have patient charts. We still have SBARS, though. Computers are not 100% reliable or 100% available at all times. I would keep some sort of paper checklist regardless of what was allowed.

[Wuzzie]

If you use a cheatsheet what are they going to do? Fire you? If paper use is that big of a deal just buy your own. Seriously, this is one of the stupidest things I've ever heard. You do you.

[mrsboots87]

Simple solution is to print at home and bring your own if they are that anal about the paper.

[JBMmom, MSN, NP]

I was just wondering about how others have transitioned to not using paper, if anyone has. I'm not concerned about the cost of two sheets of paper, nor do I really think I will be fired for using them. Thanks for any tips.

[brillohead, ADN, RN]

Our facility recent changed EHRs, and we're being told that soon we will not be allowed to have any papers for our patients.

There's a huge difference between not having a paper chart, and not being able to utilize a personal "brain" sheet during the course of your shift.

The way I interpreted the quoted sentence was that there aren't going to be any papers produced BY THE FACILITY for patients -- no face sheets, no list of orders, no printed MARs, etc.

I think you're all worried about nothing.

We have an EHR and every single nurse on my unit uses a "brain" sheet. Orders and meds and treatments and labs are all in the computer, but everyone carries a list of things to do, etc.

[JBMmom, MSN, NP]

That's what I thought at first, but we were specifically told that organizational sheets should no longer be used. All of handoff report should be in front of the computer, completely uniform among staff. I think they're making too big a deal about that point, it doesn't sound so far like anyone else works without a single piece of paper.

[Wuzzie]

I was just wondering about how others have transitioned to not using paper, if anyone has. I'm not concerned about the cost of two sheets of paper, nor do I really think I will be fired for using them. Thanks for any tips.

That's the thing. I doubt anybody has really transitioned to completely paperless. We transitioned to an EMR a number of years ago but we still use cheat sheets and peripheral brains all the time. Even if we print something out we still write notes all over it. The transition team is probably playing hardball right now to make sure the new system is fully implemented. We had to do something similar by literally taking away every single prescription pad from the physicians to make sure they used the computer.

[Orion81RN]

I completely agree with pp's. When you receive an order, what are you suppossed to do? Memorize it until you can enter it? No, we write them down. When lab calls with crital results, we dont just memorize it for paging the doctor. We write it down. Room numbers and initials should be just fine on a brain sheet.

[RNperdiem, RN]

Nobody is taking away my brain sheets. When the hospital went to electronic charting, we did save a lot of paper, but we need our own daily organizational sheets. Unless someone is policing the halls, I doubt this will be an issue.

[Nurse Beth, MSN]

That's what I thought at first, but we were specifically told that organizational sheets should no longer be used. All of handoff report should be in front of the computer, completely uniform among staff. I think they're making too big a deal about that point, it doesn't sound so far like anyone else works without a single piece of paper.

The leaders that are over-zealously telling bedside nurses do away with their "brains" do not work as clinicians. Sometimes it's best to quietly see how things play out.

[OyWithThePoodles, RN]

That's what I thought at first, but we were specifically told that organizational sheets should no longer be used. All of handoff report should be in front of the computer, completely uniform among staff. I think they're making too big a deal about that point, it doesn't sound so far like anyone else works without a single piece of paper.

This is dangerous. Not having a "brain" sheet to keep your patients information on is ridiculous. Especially if you have six patients. You could very easily give the doctor the wrong information (if they call for info and there is no computer available and perfect storm, it's an emergency). I feel this is just asking for nurses to get patients confused.

We are "paperless" and have EHR's at the hospital I work at. But we still print patient labels (for specimens), and a face sheet (for EMS should the patient need transferring).