q 15 mins charting

[annmariern]

Anyone else have a problem with this? If a pt is in restraints, we have to initial a long checklist stating we checked on them, tried alternatives, etc etc, plus q 2 hrs on meditech,more detailed charting. They have people who track this charting, but when you have 6 pts on a busy med/surg floor oh and 0.5 of a CNA, and more than one pt in restraints, how in the hell is this possible?

Yesterday alone on a 30 bed floor with 2 cnas's and 5 nurses we had 3 pt falls on one shift. But don't sign the paperwork, they are all over you. Personally I feel like I am commiting fraud when I blindly initial these things, knowing it has been impossible to do whats being asked of me, particularly when I have discussed it with my manager and been told "do the best you can". Also, how can the state or JACHO even dream this is being done. Its just ridiculous when you look at the forms and see the initials,overlapping, obvious that its done at the end of the day by some frazzled nurse?

[StNeotser, ASN, RN]

I've done this too. I've done three or four signatures in a row. Does this make me a bad person? No, because I've been doing other things that have held higher priority. I really think that this only works if there is a one on one contact. It simply can't be done honestly by someone who has eight other patients - don't know how many you have but this is my story.

[kstec, LPN]

If and when I would ever get caught for this same exact thing, I would ask the person in charge to do it with the patient load, the workload, all the paperwork, the medpass and on and on. Sometimes I wonder how in the heck they think we can do it. I work on a 32 residen, somewhat acute unit in a LTC facility, 4 g-tubes, 10 hoyers, a lot of dementia, 8 diabetics, 2 who are very brittle and so on. I have two CNA's who hardly have time to give showers, or pass water much less do vitals. My saying is "Do your best and bless the rest", why? because I am only one person and I know that I'm doing my best and after that I have nothing else to give. I often wonder if I were ever working during a state inspection, if I could keep my big mouth shut. I'm not a smarta$$, but I'm a full fledged patient advocate, and I don't know that if they asked about certain things, that I wouldn't just go ape and tell them that their regulations are not reality and if they want them to be, then fight for better staffing to accomodate all these regulations. I'd like to believe that the mass majority of people in nursing don't deliberately just don't do stuff just because. As a nurse we play a lot of different roles and have a ton of responsibilities, but yet inspectors are concerned as to whether I waited 1 minute in between each eye drop, but what about the resident who have been laying in their own urine and feces due to short staffing. Com'n, let's get our priorities straight. Well, sorry this is vent number 2 tonight and it may not be my last depending on if I log off now or not. Sorry!!!!!!!!!!!!!

[GingerSue]

just remembering what was organized at one facility when a lot of patients required q15minute checks - for each hour of the day a staff person was assigned (so at 0700 the first staff starts and does the checks, at 0800 the next staff starts, at 0900 another starts - etc). The charge nurse had to make that schedule.

Would that be possible?

Or if it is your own patient that needs the checks - could you ask someone else to do it on the half hours?