nightdove

I am sure you are a great nurse but every hospital is different. We have no cnas or unit secretaries. So much time is taken up doing paperwork. My nurses are the best of the best. They take excellent care of the pts. When they have a pt that is crashing with a low blood pressure they do what they know to do and titrate the levophed based on the patient and what it takes to stabilize them. To hell with looking g at a ******* protocol. But when they chart this event, they chart according to the damn protocol or risk getting written up. Yes the pt lived but obviously the only thing that matters when you have these idiots that just do chart audits is whether you titrated the levophed according to protocol. So if you don't get what I am saying then you obviously don't have to make these kind of decisions at night when there is no doctor around. Charting is important and I would never advocate lying but the bottom line is pt care. All I am trying to say is that all these new requirements really do nothing to help the patient. It's all about the chart. Maybe this would help a new nurse that needs a piece of paper to know how to titrate levophed but for an experienced critical care nurse, its not going to happen. They will do what they know best for the pt. And chart all the titrations based on the ******* protocol instead of what they actually did. And you think this is wrong? The pt survived. And this is wrong?

I really appreciate what you said. It totally reflects what I feel and all the nurses that I work with in ICU. Everyone does all they can for their patients. They are all excellent nurses but it is so stressful making sure you dot the I's and cross the t's. Anyone that says they can do all this perfectly is a liar. But that doesn' t matter. We all went into nursing to take care of patients. The nurses I work with strive to give the best care but having to choose between giving your time to the patient and charting all the ******** takes a toll on any good nurse. I choose the patient and if I have to ******** the charting ,so be it. Everyone I know does it. The patient comes first and to hell with the damn charting.

And by the way all the critical care physicians I work with totally agree and trust the nurses judgement. They also think its a bunch of crap.

Ok,you obviously don't take care of critical care patients that requires split second decisions. So you actually go by a protocol for titrating levophed instead of looking at the patient and doing what is best. Wow! You are obviously a new nurse, a manager, or an ass kisser. If you took care of the kind of patients that I do you would absolutely agree that all that charting on a rass q hour and making sure you go by the stupid protocol for titrating levophed instead of doing what you know is best for saving the pts life is all a bunch of crap. I have been a critical care nurse for 30 years. I am in charge of a large ICU. The charting joint commission requires takes away from patient care and is ridiculous. They have obviously never worked in icu. Let nurses do what they do best. Take good care of the patient. All that charting of a rass and following protocols is crazy because when my pt is crashing I will titrate drips based on what I know works. My priority is the patient. So I will titrate the drips to save my patient and chart whatever the hell I I have to to pass the damn audits.

I am so sick of joint commission and their ridiculous mandates on charting. They sit in some office somewhere and I am sure they have never worked in ICU and mandate what we need to chart. They say its best for the pt but in reality it actually takes away from pt care. Most nurses do what they is best for the pt and lie about what they chart. All the nurses are so afraid of getting in trouble for not charting hourly rass, starting a drip per protocol,etc that they do what is best for the pt and just lie to make the chart look good per the damn protocol. Most of us have been doing this for years and will do what is best for the pt. But now we have to lie and make it look good. Besides this it takes away from pt care to have to chart all these hourly rass if a pt is on propofol or versed. The charting requirements are taking away from pt care. Its all ********. Joint commission has nothing better to do than sit in some office and write a bunch of crap for us to do that in no way benefits the pt. Its quite obvious that they are completely ignorant when it comes to actual hand on care. More and more time in front of a computer is less time to spend with pt. Besides that we lie on the charting and do what is actually best for the pt. What joint commission requires is completely, total ********. They say its for pt safety but its just to give them something to inspect to protect their jobs. They have nothing better to do.