AMEN TO ALL THE ABOVE REPLIES SO TRUE.
The paperwork is atrocious and though chartingby exception is catching on,the institution i work at now insists on narrative on several of the things that are already on flowsheets such as there is a spot to check that the iv is secure and site is okay but then yu have to chart the same thing in the narrative why?
The computer systems are unfriendly to put it mildly--and instead of everything being available in one system we have one system for orders and another for scheduling and another for labs so we have to log off one and log in to another to get info.
Then there is the ancillary services issue--the housekeepers can't clean the room until you have stripped it. If there isn't a housekeeper then guess who gets to clean--the last institution i worked at the housekeepers weren't allowed to touch the monitors at all so we had to find a dust mop to clean off the top of the monitors. why?
As for Tara's comment about different expectations for male and female nurses----boy is she right. The last institution i worked for did!!!!!! Unfortunate but true.
The female nurses were expected to be more thorough in patient care, more flexible in respect to schedule changes, more accountable for everything, quieter, more polite, more respectful. should i go on.
The male nurse were always having excuses made for them--they could tell the raunhiest jokes within patient hearing and never have a thing said to them--a female nurse making a mild off color comment at the desk that the patients could not hear was reprimanded.
when asked why the difference, the unit manager's response was "boys will be boys" attitude was also directed to noisy behavior, work not done, anger, irresponsible behavior, not coming to work after being on call because they were tired but female nurses were penalized if they didn't work their regularly scheduled shifts
after being on call. I could go on and on. The double standard is alive and well and living in several hospitals. This is part of the reason i left my last employer and my new one seems to be a lot better in equal expectations for male and female nurses. I'm not saying that all hospitals have different standards for male and female nusrses but that some do and it's sad. at the last institution i worked at the female nurses had been complaining about the conditon we received the patients from OR for years--things like the patients arriving in PACU with blood and betadine all over them and their patient gowns, the gowns soaked with irrigation solution and God knows what else, on a cart with another patient's name on it, no ID band the list goes on--we were repeatedly told that the OR
staff was too busy to worry about the little things. A new male nurse went and compained to the manager and the next day there was a
comittee set up between the OR staff and the PACU staff to investigate this problem and do something about it. One time i approached the manager about getting OT and
the social worker to see a female doctor's axiallary node dissection patients preop because she was sending so many of them home post op and those two departments were frequently gone by the time the patient was a wake enough to talk with them. It was a patient care issue and made sense to me. The unit manager went off about being tired of spoon feeding doctors and she should take care of it from her office etc. Two days later i got in trouble with the same manager because i didn't have a male physician's billing forms available on the unit for him. This was a female manager.