amanda_kay,RN

I can tell you the reason the nurses just click, click, click.. The 'IPOC' is just a reiteration of everything you have been doing for your patient, and nine times out of ten, you are going to choose progressing.(because your patient is progressing through your plan of care) For example, if your patient comes to the hospital with a blood glucose of 300, chances are you are going to initiate a plan of care that addresses abnormal serum glucose. You will be checking your patient's blood sugar regularly, administering insulin, giving a carb consistent diet, teaching about the disease process, consulting a nutritionist, etc. Sounds to me like a decent plan of care, right? Well, you can't just do your plan of care. We have to meet quality measures and prove that we do have a plan and we are acting on it. So even though you know and I know you have identified a problem, chosen a plan of actions, intervened, and reassessed, you have to prove to anyone accessing the patient's records that you have done those things. So, we click click click on our chart, chart, chart! That is the purpose of the IPOC.

Hello fellow nurses! I have been in the healthcare field since I was fifteen years old. I worked as a lifeguard in high school, then became a CNA, LPN, and RN (ADN). I worked in a Skilled Nursing Unit as a CNA/LPN, and my first job as an RN was in intensive care. The first year was a challenge, one that nursing school could never have prepared me for. I did well in nursing school and I am a confident individual, but I was broken on many occasions. Most days it was all I could do to put my scrubs on and drive myself to work. Just learning how the technology worked- the computers (charting), monitoring devices, the phone system, pagers, faxing machine, etc. was stressful. Then there were all the tasks I thought could never be accomplished in a 12 hour shift: assessments, charting, medication administration, starting IVs, drawing blood, more charting, calling physicians, bathing, turning, more meds, more charting, etc. And that was if the night was routine and patients were stable. Getting an unstable admit at 0200 while there was a code in progress on the unit was enough stress to make me feel ill. And on top of the learning curve, I was trying to develop relationships with other nurses, learning how to effectively communicate with physicians, and how to speak to concerned family members about their critically ill loved ones. All of these things are still difficult, but I have now been working in ICU for a year and three months, and I have made it past the worst of it all. Though I sometimes have pre-work jitters, I would say I am much more comfortable in my role. Unfortunately, I am having a hard time finding satisfaction from my work as a registered nurse. I leave work feeling exhausted and defeated. Although I am sure I have helped people to some degree, in many occasions I feel like I could do a lot more for my patients, but don't have the time to do it. We are constantly having meetings for quality improvement and how we can improve patient satisfaction, but it always ends with more tasks or more charting on our part. How can I do more for my patient when my list of tasks is lengthening and I have to spend more time on the computer? And how can I do something for my patient if the doctor won't provide an order (which is the case when you get an 'on-call' physician on the phone who doesn't know, and or have any interest in your patient)? Although this isn't always the case, I believe every nurse has been in that position at some point and understands where I am coming from. Bottom line: I know that not everyone's job is perfect, and we are going to have a bad day now and then. But I am utterly disappointed with my career. I do not like the healthcare system. I enjoy being challenged, I like to learn, and I love to feel like I can help people and make a difference. I am 22 years old, and I have known for some time that I was going to go back to school, however I am not sure what I want to do. I am willing to put in the time, effort, and money to get a masters of even doctorate degree. I have not obtained my BSN yet because I am not sure I want to stay in nursing. Maybe I would enjoy being an advanced practice nurse, but I just have so many doubts about my field. I have thought about PA school too. Is there anyone out there with similar frustrations? Does anyone have any career suggestions? I have been doing research on career options, and I know some nurses venture away from the bedside to work in business or legal. I was hoping to hear ideas from people with similar experiences, or hear success stories from people who have found happiness in their profession. Any input would be greatly appreciated!!