Status quo or is the grass indeed greener?


Hi there everyone! My unit is in full Joint Commission prep mode and nothing regarding that bothers me so much. I am slightly concerned because I am currently on my fifth nurse manager in less than 2 years. None of our unit's policies have been updated since 2013 with best practice research. I am greatly concerned that hospital policies provide conflicting guidance in many different aspects of my job (medication disposal procedures, fall risk avoidance policies, no obvious performance improvement projects, etc). Additionally, this is my first job as an LPN (about 2 years here,) but not my first inpatient position with more than 10 years in healthcare in one form or another.

In the midst of all of the above, I get so frustrated with what I am told is normal for care systems in my environment. Getting pain medications for a fresh PACU transfer can take more than an hour because the order to transfer has to be activated in one system, then an RN has to acknowledge the new orders for the patient once the Pt arrives in another system, then the pharmacy has to review the orders but usually this requires at least one phone call to notify them of the transfer and usually three or four more because the pharmacist has yet to acknowledge them, then the orders are rewritten by the clinical pharmacist and then reacknowledged by an RN, and then there aren't always loaded into the Pt profile in the Pyxis without repeat phone calls to pharmacy. On several occasions I have had to have the Docs call the pharmacy as my Pt is howling in pain following the transfer. And nothing on my end can expedite this process. Pretty severe example, but this type of issue extends to other ancillary service interactions and often even the mundane tasks like getting ice chips becomes a six step process because this ice machine is broken, or the substitute ice box is empty, or visibly contaminated and has to be cleaned.

I came to the conclusion that nursing is to some extent coordinating all care for an inpatient and that there will always be unforeseen speed bumps in that road, but is it always and everywhere a case where even simple tasks are unbelievably convoluted and waste valuable time? Is this how inpatient nursing is now and I need to resolve myself to this?

Thanks for reading the novel if you made it this far!