who has time?

[stumpy1]

:(I am concerned we are leaving a large knowledge base of patient care behind as we move forward electronically. It is very easy to "show off" technology and how we are "experts" in nursing. My concern is helping older nurses and those of non English ethnicity using the most valuable tool ever invented in patient care. I see many younger nurses viewing only computer data rather than learning to ascultate lungs, suction, or turn the patient to prevent breakdowns. We are increasing the average length of stay for patients by not performing routine ADL's on each patient. I have NEVER refused to clean a patient when they have vomited or soiled themselves. Have you? or assigned it to a technical nurse due to odor?

I was recently in an Emergency Room and the assigned nurse did not even check to see if I had a call light or attach me to the monitor. She prejudged my condition and did not know my family history includes sudden cardiac death. Need I continue?

[november17, ASN, RN]

You can blame the insane amounts of charting that have been introduced in recent years as part of the problem.

[stumpy1]

Amen to that. I would like to condense information and only concentrate on the information that is essential in a court of law showing excellent nursing care. The rest is superfulous and will eventually burn up anyway. Thank you. :typing

[Natkat, BSN, MSN, RN]

I see many younger nurses viewing only computer data rather than learning to ascultate lungs, suction, or turn the patient to prevent breakdowns. We are increasing the average length of stay for patients by not performing routine ADL's on each patient. I have NEVER refused to clean a patient when they have vomited or soiled themselves. Have you? or assigned it to a technical nurse due to odor?

I was recently in an Emergency Room and the assigned nurse did not even check to see if I had a call light or attach me to the monitor. She prejudged my condition and did not know my family history includes sudden cardiac death. Need I continue?

Hmm. Do you mean "young" nures or "new" nurses? I just graduated in May but I'm certainly not young.

I think that has more to do with who the nurse is, her work habits, her values, etc. I can't speak for all new grads, but I think I'm very vigilant about doing assessments, listening to lungs, etc. Even though, as a dialysis nurse, much of what I do is monitor a machine, I still do quite a lot of assessing my patient. I listen to heart and lungs, look them over head to toe, look at their skin color, look at their nail beds, and so on. I can tell you first hand that even with all the computer-based learning we did in nursing school, we were taught excellent assessment skills as well. We were taught that if something alarms or changes on the monitor, the first thing we do is look at the patient, then look at the monitor.

There are many who feel that computers are the ruin of our civilization. I think of a computer as a tool like a pen, a piece a paper, a stethoscope, a pair of tweezers. It's just something else we use to do our job. For many people computers are so much a way of life that we integrate into what we do every day, and don't focus on it like a moth to a light bulb. We can use the computer and at the same time, focus on our patient. Even though I'm not responsible for the primary care of a patient, if a nurse needs help cleaning a patient, I'll help her (or him) the best way I can. I've only been a nurse for a short time and I've never seen a nurse refuse to clean up a patient, and I see many different nurses all the time.

As for call lights, I was in 2 different facilities that week that didn't have call lights in the room I was in. I asked someone to bring them, and in both cases I never heard about or say a call light. If she didn't attach you to telemetry, she's not doing her job, but you can't blame that on computers.

[stumpy1]

:yeah:Bravo! You have assessed the situation accurately. My question is how do we encourage others to deliver the same care you are. The computer is a tool that older nurses steer away from. My concern is we are overlooking assessments that will show up prior to changes in computers, monitors, etc. For example, a patient with a pulmonary embolus may be short of breath ambulating to the BR. He/she may not develop O2 sat changes until they develop a crisis state. You are an asset to our profession. Thank you.

[TopazLover, BSN, RN]

Sorry you had such a poor experience and a scary one at that.

I may be accused of stereotyping, but, IMO there are differences in generations of nurses. Much has been written about the differences and I believe you may have seen some of the effects, not always positive.

We nurses, older and having grown up with a work ethic from parents who had seen or heard lots about the Great Depression, had it indoctrinated by the age of 3-5 that hard work is good. We were expected to be complete in our work and there was never an excuse for things like lack of call lights, incomplete assessments.

That said, younger nurses have it all over us in terms of actual knowledge base. I just think sometimes they focus on what they have learned rather than the "common sense" we think of as common.

I guess our job sometimes includes being clear with our education of these nurses about the field and the basic requirements that must be met before worrying about lab results, etc.