question nurses at the bedside

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I was asked what would keep nurses at the bedside of PT more?

my answer: Round every hour to decrease call lights?

I am unsure if this is correct. Any suggestions

Yeah ive heard they take 7 on med/surg at night too..im on a CT surgical/Vascular tele floor so it usually 4 on days and 5 at most on nights

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Yes...they type of floor makes a HUGE difference. I have always preferred the critical care areas and acute telemetry/stepdown units....I prefer that nurse patient ratio much better. If I can't be in the ER I'd rather be in CTPACU

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I'm a LPN on sub-acute rehab floor

We have 20 pt

With

FS

Vital signs

Treatments/dressing and breathing/neb

Medications

Charting

IVs

So less pt ratio, would give me more time with each pt at bed side.

I'm in RN school now, and that seems to be the biggest concern.

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Specializes in Progressive, Intermediate Care, and Stepdown.

I wonder if staff ratios, better assignments, and a less work load is going to happen. I read regularly and hear often that its' the direct opposite. People are even more concerned because of the new healthcare issue. More work/responsibility for same or less pay.

On a tangent. Sorry.

Delegate tasks more to appropriate personnel. ADLs are time consuming.

Shh...Have doctors do more direct patient care and ADLs. :p

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Specializes in ER trauma, ICU - trauma, neuro surgical.

I think a hospital that has gone smoke free has given nurses more time at the bed side and stopped other nurses from passing the buck. When I worked in the ER, there were nurses who would go outside to smoke every 2 hrs and I had to pick up the work. Drives me crazy. As soon as someone was getting admitted, the nurse would magically disappear for 20 mins and I ended taking admit orders over the phone. Then, those nurses complained if whet to get a soda, while they left 5-6 times a shift. Funny some nurses ended up being bored when they weren't allowed to leave the floor all the time.

The other thing that would give us more time is doctors actually entering orders on the EMR. Our census used to be low all the time, but as soon as we went live, everything came to a stop. Between the complaining and making nurses enter their orders, things move very slow. Then, I have to check the chart every hr, over and over, until the orders that I was told about 4 hrs ago actually pop up on the EMR. If it doesn't, I have to call, and then wait again. Then, there's the docs who call on the phone before reaching the floor (so I can enter the orders), then they swing by 5 minutes later and enter a progress note. I will have pts who are ready to go to the floor during the morning, but the orders don't pop up until 5 pm. The docs wait till the end of the day to sit down and do all the orders at once. I have no problem what so ever entering an order via the phone or getting one that I need now. I don't expect docs to drop what they are doing and enter an order. But, waiting 4 hrs for an order is ridiculous. I have to spend each day going through charts and discontinuing order myself. There are 6 duplicate orders for vital signs and 3 different IV rates. I have to call and ask which one should be followed. The other two rates should have been d/c'd by the doc, but it's ended up being my job. Sometimes, I am d/c'ing orders that are a month old (and completed). We were told the docs are going to be entering all orders, that it was going to be faster, and they would d/c inactive orders. This is not what is happening.

It's funny that during the paper charting times, there were docs who always wrote 2 pages of orders. Do this, then this, then this, wait this long and check this, send this. As soon as we went live, wouldn't ya know it, they only enter like 4 orders now. I guess computers have improved diseases.

I have no idea what it is like to open a chart and see only active orders. Some doctors hate the EMR so much that they actually tell us that the orders they want are in the progress note and it is our job to read their note and carry it over into EPIC. The reason....they don't have time to do both. The EMR takes up so much time of my day. The nurses were taught how to use the EMR well before the docs, b/c we were supposed to be the safety net when the docs went live. I have learned that we are not the safety net, we are now the unit secretaries. I have no problem taking TORB orders and I understand days can be busy, but I was told that we were no longer the ones entering orders. I can enter orders pretty fast. I learned how and where to orders can be found quickly. Doc don't learn how to enter orders fast. Some refuse to learn where some orders are or how to enter something at all. If it takes longer than 10 sec, they just pass it on to the nurse instead asking where the order is. Why should they? Just let the nurses do it. Then again, I shouldn't be surprised. There are some docs that still ask us to print out their patient list for them. If I mess up on entering an order or a nurse is completely lost with the EMR, they are sent to a refresher course. If a doc has no clue, they defer to the nurses. And that takes up so much time of my day.

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How do u like EPIC? Our hospital systems are in the midst of changing to EPIC

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I like EPIC now. You can check your work list that will tell you when tasks and meds are due and alert you to orders that are new and need to be acknowledged. I really like the note section- you can actually read a progress note and make out the the MD's name!!!

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