state is threatening to go after license over precharting

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This is not me I am talking about. They could get me on same charges if they searched enough charts but lucky I have not done it in a while. I know two nurses who were found to have charted things before they did them and state inspectors called it fraud and are threatening to bring them up before the board. The facility has gone to bat for them and stated such extreme measures are not necessary. All they say that is necessary is a education program. The facility is right because half the nurses I know would lose their license(including me) for precharting on one occasion or another. For instance, say it is 1pm and the patient is on a q2 hr treatment. I know it is very hard to get back to chart something at 3pm so I will sign off on the thing I know I will do at 3pm. I don't think I have ever signed off on anything in advance that I did not do. In the future I will take the risk that it never gets signed off rather than sign it off ahead of time. Apparently, presigning is a much more serious crime.

exactly leslie. So i just love it when people tell us "not to take it anymore" but offer NOTHING in the way of truly viable solutions. I have yet to figure out how to make management and JCAHO stop

this madness. Anyone?

a true viable solution would be to just not finish your work by the end of your shift, secondary to unrealistic workloads.

can you imagine if all nurses (with said heavy workloads) reported to their nm and oncoming shifts that they were unable to finish because of a, b & c?

that's why unity is so important.

just recently i worked an 11-7 shift where i had to take 2 out of 3 carts....and even on 11-7 there were plenty of meds to be given as well as treatments.

this other nurse i worked with was the house supervisor that noc and when i asked for some help, she retorted that 'agcy nurses do this w/o any problem and they take long breaks'. my response to her was that they were not doing their job; they were precharting as if they had actually done this care.

now this is on a subacute/hospice unit where there are plenty of demanding patients as well as patients in poorly controlled pain.

even at my last job, there were definitely times that i just could not finish what was expected of me; and they actually expected me to stay until my work was done, w/o the overtime.

so rather than cutting corners and compromising care, i would love to see how mgmt would react if all nurses reported unacceptable working conditions and just did not finish their work r/t unrealistic workloads.

leslie

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As for me, I will ALWAYS prioritize with my patient care. I didn't go to nursing school to be a nurse to ridiculous charting systems. No brainer for me. If I provide good care and chart this to protect myself, I sleep well at night... all the rest of the stuff is secondary.And I do ignore some of it. If management doesn't want to listen that we don't have enough hours in the shift to complete all their ridiculous QA's and quadruple charting systems, I WILL decide based on my own priorities. Works well for me.

What works best of all of course is if nurses will stick together and speak up, but that doesn't happen frequently in my employment at will area. (altho I HAVE been involved in 'passive ignore' campaigns by whole shifts of nurses...and sometimes management gets the point, other times not). Individually, we do the best we can.

I've had day nurses I follow finally escape the unit...totally exhausted...they're 14 hrs into a 12 hr shift with zero charting done...they've shut down. Management doesn't care but browbeats them about OT. Me as the following nurse: I do what I have to to ensure the patient I'm taking over is safe first, then address the problems from that standpoint.

What bugs me is when nurses drag coworkers to peer review over their paperwork. These are management bootlickers who do this IMHO, and I see waaay too much of it. How is the nurses' patient care...thats what I want to know first. If thats good, then everything else can be dealt with in its own time.

JMHO from the real world. ;)

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and God knows there are plenty of bootlickers out there.

but i just wish that everyone shared the same priorities of patient care first and whatever else you can finish, either you can or cannot. period.

and we wonder why nsg is one of the most divisive professions out there; and why there are such problems with our image.

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a true viable solution would be to just not finish your work by the end of your shift, secondary to unrealistic workloads.

can you imagine if all nurses (with said heavy workloads) reported to their nm and oncoming shifts that they were unable to finish because of a, b & c?

that's why unity is so important.

just recently i worked an 11-7 shift where i had to take 2 out of 3 carts....and even on 11-7 there were plenty of meds to be given as well as treatments.

this other nurse i worked with was the house supervisor that noc and when i asked for some help, she retorted that 'agcy nurses do this w/o any problem and they take long breaks'. my response to her was that they were not doing their job; they were precharting as if they had actually done this care.

now this is on a subacute/hospice unit where there are plenty of demanding patients as well as patients in poorly controlled pain.

even at my last job, there were definitely times that i just could not finish what was expected of me; and they actually expected me to stay until my work was done, w/o the overtime.

so rather than cutting corners and compromising care, i would love to see how mgmt would react if all nurses reported unacceptable working conditions and just did not finish their work r/t unrealistic workloads.

leslie

Just not finishing my work may well put me in the same situation as charting in advance might. Trouble with a Capital T. I don't see this as a solution. And no, I am NOT returning on MY time to chart later. When I leave work, I am not coming back til scheduled again! I have a homelife to preserve.

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agency nurses usually get more help than staff...i have always tried to do anything i could do esp if they are only around for that one night...though i had one who was called in every weekend and could not understand why everyone 'suddenly disappeared' [her words].

..doing your work is a priorty...chart and get all peritinent info in...if you run out of time toss the ball into their court...'do you want me to leave now or do you want some of this paper work finished' take notes or use a pda or tape recorder so that when you go to chart you have all info at fingertips...if you can find a private place to finish up all the better...you won't be interrupted with "gee you wouldn't mind helping with this would you...it will only take a sec " if you can't get the space, learn to say no

if you had gone home on time you wouldn't be there and they would have found a way to get it done***stick to your guns

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Just not finishing my work may well put me in the same situation as charting in advance might. Trouble with a Capital T. I don't see this as a solution. And no, I am NOT returning on MY time to chart later. When I leave work, I am not coming back til scheduled again! I have a homelife to preserve.

it's certainly not an ideal solution but if enough nurses did it, it would force mgmt. to re-evaluate the situation.

how do you suppose mgmt would respond if all nurses from all 3 shifts did not finish their work because of aforementioned reasons??

i truly don't see every single nurse getting in trouble over this as they could not afford to lose their staff.

but i'd much rather do it this way then prechart care/meds that i did not render. the risk of losing my license is not near worth any of this.

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it's certainly not an ideal solution but if enough nurses did it, it would force mgmt. to re-evaluate the situation.

how do you suppose mgmt would respond if all nurses from all 3 shifts did not finish their work because of aforementioned reasons??

i truly don't see every single nurse getting in trouble over this as they could not afford to lose their staff.

but i'd much rather do it this way then prechart care/meds that i did not render. the risk of losing my license is not near worth any of this.

BINGO! :idea:

When ALL nurses on a unit insist on enough staff and include an action management has no choice but to pay attention. It is NOT good to be the only "troublemaker".

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he was scheduled for a 10am pain reliever. the nurse initialed the mar before she gave it, then noticed they were out of that drug. then she got busy and forgat to order it.

pre-charting is one thing, but pre-charting about narcotics is a whole other story. personally, i will chart after the fact as opposed to pre-charting. just put the time it was actually done and the time you are entering it into the pts chart as "late entry". i think the bon would be easier on a nurse who was honest with her charting (even if its charted later than it should have been), instead of a nurse that was caught pre-charting.

never ever ever ever do anything that raises questions about narcotics.

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So many nurses whine about conditions among themselves, but will not speak up...and when one of us 'troublemakers' DOES speak up, they scatter like roaches and leave us standing alone. BIG problem in our profession. Who can blame nurses who speak up, get burned a few times, then finally go into self preservation mode out there? I guess I can understand it. We really have to walk a line, particularly in states like mine.

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DANG!!! I don't have time to prechart. I'm lucky to get charting done w/i the 2 hr time frame my facility requires.. it has a computer system that allows us to change times, but, the permenent record shows the actual time and the time you changed it to. We are very JACHO compliant, but ,would this be beat to death in court??? It really feels like I should have been a stripper, seems much more admirable.

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I had this one clinical instructor who was worse than a drill sergeant. "NEVER NEVER Prechart" she would say. I can still hear her voice and it haunts me at night. :chuckle I think I don't do it 'cause I'm so anal about stuff like that. I would hate to get caught.

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Exactly.

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If the manager "counsels" you for OT charting, they are stealing money from you for your time worked, and they are orderdering you to violate the nurse practice act - now try to report them for this and see what happens to you and your license.

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BON investigator AND common sense? ???????? These concepts are incompatible.

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