I’ve been a RN for a year in the ICU. Our clinical educator is a woman in her 60’s who generally seems to be well liked and gets along with everyone, although being the clinical educator she can be seen as annoying sometimes - I suppose that comes with the job. But she doesn’t seem to like me.
There have been two occasions where she has inappropriately approached me about an unrelated topic while I’m doing my morning assessment on a patient. The first time she was in a panic asking me if my BLS had expired because she didn’t have it on file, in a patient’s doorway. Today she came up behind me while I was suctioning a vented patient and asked me, “What the hell happened to you yesterday?” in regards to me not showing up to an optional class I had forgotten about. She was almost sort of grilling me and told me myself and another person hadn’t shown and she was livid.
I think this is inappropriate and I’m almost tempted to speak up because this is the second time she’s done something similar, but curious to know everyone’s thoughts.
I've been in both. From experience I can tell you that it is NOT administrations fantasies about your documentation, it's insurance/CMS. Administration only pushes what those entities require to pass inspections or for billing purposes. If they could just say "Yo, BlueCross, we took care of JKL33, gave them some NS and Midol. That'll be $4500", they wouldn't give 2 poops whether you checked that patient every hour for the last 14 days.
In all honesty, I don't get why we as nurses get so worked up over documenting. If you do it, diligently, it's covering our *** when a Dr messes up and administration is trying to push it onto us.
I see both sides. Many people don't, which is why I point it out. If administration knew you could do proper documenting and meet all the BS criteria set up by the outside entities, they'd let you do it on paper, because it's a hell of a lot cheaper than paying for all the IT stuff that comes with an EHR.
I'm not at all unfamiliar with the actual requirements for documentation and my comment wasn't a rally cry against basic documentation. Nor was it a complaint about EHR vs. paper.
I also don't spend my time on documentation to cover my body parts for when a doctor messes up (nurses love that theme, tho, don't they!). I generally do it first and foremost because it is the record of the patient's health situation/treatment, and then also because it is a legal record and is required for payment of services.
My experience has been that a great many documentation requirements/necessities are made worse by administration's choices.
Example: Standard of care is that X population be screened for Y. Administration: Well that's too complicated. Screen every patient for Y.
Example: Group of patients need to be triaged (continuously). Triage is a process whereby the patient's acuity is quickly determined so that they can be directed to the appropriate level of care. There is a whole manual about how to do this efficiently. Administration: "Triage" is a 10-minute process that includes a bunch of unnecessary information. Oh, and don't forget to assign a level of acuity.
Example: XYZ thing must be documented for payment purposes. Administration: And then also go over here and document it there and there, too, otherwise Suzie Q over in data abstracting won't know where to look for it. Or Suzie doesn't have access to that one part of the EMR so you also have to also put it where she can see it.
Example: When you get an alert about X patient condition, acknowledge it by clicking here. Begin documentation on the X interface. Administration: And also begin filling out this here audit form where you will write down everything that you are documenting the EMR during this major situation, and then when you are done with patient send it to mail code # blah blah blah so that the quality team doesn't have to go in the EMR to find all of that data.
Yeah I guess it kind of goes without saying. ? I'm aware; I just can't help myself. In this case I generally dislike the assumption that staff nurses are ignorant of the "LAWS" that supposedly dictate every single one of administration's actions word for word.
I think I may have been the original “mean old biter nurse.” And one of the original Crusty Old Bats. A newcomer was trying mightily to insult some of us more seasoned nurses and misspelled “bitter.” Hence the “biter nurse” and “crusty old bat” society.
I think I may have been the original “mean old biter nurse.” And one of the original Crusty Old Bats. A newcomer was trying mightily to insult some of us more seasoned nurses and misspelled “bitter.” Hence the “biter nurse” and “crusty old bat” society.
I wouldn't have even acknowledged her, I would have finished what I was doing. Tell the patient I'll be right back I need to discuss something with a coworker. Then I'd rip her head off and *** down her neck. I'd tell her I didn't see you or anybody else offering to watch my patients while I went to the class. And I'm not going to leave the unit unless I have a nurse to relieve me. Reschedule it for another time and make sure they have staff available to cover me. I'd love to sit and chat but I have a bunch of treatments I have to go do on my patients. And I'd walk away.
Specializes in Physiology, CM, consulting, nsg edu, LNC, COB.
My old friends, I have just spent an entire afternoon rereading the epic Mockery of Nursing thread (Thanks for the link). My old posts are in there under an assigned alias after the {{whatever the big reorg was}} and just because I could, I gave out a lot of “likes,” to you all and even to myself, LOL. I miss you. I was so sorry to see that multi factorial free-flowing hash cut off to more comments.
That was a real community. How I would love to see some of those threads again! Lung Butter scrubs! Pearson Vue! If I have a conviction for DUI / shoplifting / felony can I still be a nurse? Fomites! Comic Sans! Those great little emojis :bluecry: :wavey: ! My preceptor hates me! It was like a never-ending meet-up where the conversations keep drifting around, great fun.
That made me wonder whatever happens to the #of posts, articles, and likes we had before that? I had something like more than 13,000 posts back in the day. I wonder if amnesty would restore them to all of us? Or were they lost electrons? Or maybe it’s best we are sort of born again. I dunno.
JKL33
7,038 Posts
I'm not at all unfamiliar with the actual requirements for documentation and my comment wasn't a rally cry against basic documentation. Nor was it a complaint about EHR vs. paper.
I also don't spend my time on documentation to cover my body parts for when a doctor messes up (nurses love that theme, tho, don't they!). I generally do it first and foremost because it is the record of the patient's health situation/treatment, and then also because it is a legal record and is required for payment of services.
My experience has been that a great many documentation requirements/necessities are made worse by administration's choices.
Example: Standard of care is that X population be screened for Y. Administration: Well that's too complicated. Screen every patient for Y.
Example: Group of patients need to be triaged (continuously). Triage is a process whereby the patient's acuity is quickly determined so that they can be directed to the appropriate level of care. There is a whole manual about how to do this efficiently. Administration: "Triage" is a 10-minute process that includes a bunch of unnecessary information. Oh, and don't forget to assign a level of acuity.
Example: XYZ thing must be documented for payment purposes. Administration: And then also go over here and document it there and there, too, otherwise Suzie Q over in data abstracting won't know where to look for it. Or Suzie doesn't have access to that one part of the EMR so you also have to also put it where she can see it.
Example: When you get an alert about X patient condition, acknowledge it by clicking here. Begin documentation on the X interface. Administration: And also begin filling out this here audit form where you will write down everything that you are documenting the EMR during this major situation, and then when you are done with patient send it to mail code # blah blah blah so that the quality team doesn't have to go in the EMR to find all of that data.
I could go on and on.