Waste of Time

[casper1]

As Nurses we are pulled in multiple directions simultaneously. We have so much to do and little time to get it done. I don't mind hard work, but when my time is wasted it makes me mad.

I resent having to spend 20 minutes looking for an IV pole so I can start an infusion. I resent when a Doctor order 1 mg of Dilaudid every hr, when the vials hold 2 mgs. The patient is asking for the medication hourly, I don't mind giving it, but every hr I have to spend 10 minutes looking for someone to waste with me and wasting the drug.

I see things like this a tremendous waste of our valuable time. Time that could be better utilized in patient care. I miss breaks and meals because I get behind, primarily because so much of my time is wasted looking for equipment, trying to decipher Doctors handwriting, being ask by Doctors to find charts, the list of thing that waste my time is endless.

Question, What do you do at your job that you feel is a waste of your time ?

[Up2nogood RN, RN]

I wish the people who make Dilaudid in only 2 mg vials would also make them in 1 mg sizes. How often do we give a full 2 mg? Morphine comes in multiple size vials at our hospital, so why can't Dialudid?

We have 1mg syringes of dilaudid! They do make them to use with a carpuject!

[Up2nogood RN, RN]

Med Recs. Every patient that comes through our ED needs to have a computerized med rec done, with spots for last doses, too. It's a ridiculous time-sucker that aggravates me to no end.

Double charting. If the computer is so magical, why can't I put the info in once and have it appear all over the freaking place? And if I put in the the computer, why do I have to write it on a paper record too?

We have those pesky things too that have to be printed out. But they aren't done in the ED, only if the pt is admitted. What is a joke though is we have 4 FT 'med rec' nurses who will enter your med rec in the EMR, if you can get a doc to fill out the old school form. Just fax em the form and the registered nurses will do some good ol' fashioned data entry maybe within 24 hrs

as they only work day shift. What a waste of a nurse's time.

[General E. Speaking, RN, RN]

Spending wasted time graphing vitals from the computer screen onto paper. Many times you have two patients on pressors each needing Q15 min vitals. Our hospital's ol'-timey computer system bites and if you get behind even a few hours, it is a nightmare and BIG waste of nurses time.

[General E. Speaking, RN, RN]

Every MWF each RN has to sit down with these 2 board members on the case management review team--the real "High Ups" (one is an RN and one is an MD, neither of them practicing any longer except on this review board) and "talk with them about our folks" --direct quote. Their job is essentially to get the patients out of the hospital the second they are ready and not a moment after. So they come after the nurses to "get the scoop" (another direct quote) about why the patients are here and "why haven't they been discharged yet." Each nurse has to sit down with these people individually and get hounded with questions..takes about 15 min. at least..RIGHT in the middle of your day..and if you say you're too busy to sit down and discuss with them you get in trouble. The thing that gets me is, every single question they ask you, can be found in the chart. If they just LOOKED IN THE CHART THEMSELVES. And the real clencher is, half the time, these board review members know more about the patient than we do! Example:

RN: so Mr. Smith is 65 and here with diverticulitis. He's on day 2 of antibiotics.

Board member 1: Which antibiotics?

RN: cipro and...hmm I am not positive about the other one because he only recieves it on night shift

Board member 2: It's flagyl.

Board member 1: and did he come from home or from assissted living? and where is he going to go after discharge? and has he had his pneumonia vaccine?

RN: he came from home but I don't know if he'll go back there after discharge or to assisted living. I don't know off the top of my head if he's had the vaccine but on admission the screening form was filled out so I'm sure it's fine.

Board member 2: Well his daughter wants him to go to assisted living after discharge and the case manager is already working on it.

ARE YOU KIDDING ME!? #1: If you want to know this pt diagnosis, which antibiotics, and his vaccine status, look in the freaking chart. #2: I never understand how Board Member 2 knows all these things about the patients..and if she does, WHY is Board Member 1 sitting here asking me the questions that they already know the answers to!?! and #3 Isn't this entire converstation more suited for the case management team..not the RN anyway? And this discussion happens for EVERY patient we have. EVERY Mon. Wed. and Fri. right in the middle of our workday....usually around 10:30AM

If that isn't a waste of time, I don't know what is. And yes I realize that was an insanely long rant..but I literally think that is my biggest administrative pet peeve in the entire world...once again the nurses are supposed to do and know everything, and don't worry, we have plenty of time to do it, and with a smile on our face to! :-)

We have these too! Horrible time-suckers.

[Nurseinprocess]

The other night I had a patient tell the PCA that she needed me....... to fix her call-light . Right in the middle of 6 am med pass, of course. I wish my pts realized what things they should ask me for, and what things they can ask the PCA to help them with! I can do everything the PCA does, but they cannot do my job, which makes my job double the work if nobody is asking them to fix anything or fetch stuff! Apparently I am supposed to be a waitress, housekeeper, nurse, phlebotomist, handyman, secretary, etc. If only I actually had time to be all those at once!

[eegrnbsn]

The other night I had a patient tell the PCA that she needed me....... to fix her call-light . Right in the middle of 6 am med pass, of course. I wish my pts realized what things they should ask me for, and what things they can ask the PCA to help them with! I can do everything the PCA does, but they cannot do my job, which makes my job double the work if nobody is asking them to fix anything or fetch stuff! Apparently I am supposed to be a waitress, housekeeper, nurse, phlebotomist, handyman, secretary, etc. If only I actually had time to be all those at once!

I hate this! All the time the patients will put their call light on "I need to see my nurse." When I go in there "What do you need?" The patient says "I can't find the TV remote." or "I need my dinner warmed up." Really? These are the people who won't tell the secretaries what they need over the call bell system, just "I need to see my nurse." Do they really think I am the only person who can help them with these things and/or I am not busy with anything else!?

[RosesrReder, BSN, MSN, RN]

Oh yeah, the redundant charting.

Ex: Our NICU. Having to chart that the hep B was given and where etc......

1). On the signed consent sheet of course.

2). The front of the chart (on a sticker) to alert everyone Hep B has been given.

3). On the E-mar.

4). On the unit's "hep B log record"

5). On the flowsheet and carried over each shift.

6). On the teahing sheet along with when the next 2 doses are due.

Same deal with the corificeat challenge, parental CPR, hearing screens, newborn screens and ROP exams if applicable.

So stupid! One or two places should be enough. If you miss any of these places, a nast-o-gram will follow, ugh!

[morte, LPN, LVN]

Med Recs. Every patient that comes through our ED needs to have a computerized med rec done, with spots for last doses, too. It's a ridiculous time-sucker that aggravates me to no end.

Double charting. If the computer is so magical, why can't I put the info in once and have it appear all over the freaking place? And if I put in the the computer, why do I have to write it on a paper record too?

it would require a better, more comprehensive program.....and the computer charting is not for nurses but the end users, researchers/docs et al

[Not_A_Hat_Person, RN]

I worked at at ALF where PRNs had to be charted in up to 5 places. All PRNs wer charted in the MAR, the chart,and the communication log. If it was a narc, it also went on the narc sheet. If it was a pain med, it also went on the pain flowsheet.

[canesdukegirl, BSN, RN]

I agree. The double/triple/redundant charting we have to do is dumb.