You have GOT to be kidding me!

[Antikigirl, ASN, RN]

So we had a chart audit yesterday and I was privy to some interesting info about documentation of Patient Education!!!!! IT floored me!

Okay...we have a place to document patient eduation. You list a general term of what you taught (like for me yesterday "pillow assist with coughing"...a code for how you did it (V=verbal R=Reading materials, D=demonstration and O= other and must document what that was), then patient understanding level (like D=doing...patient demonstrated understanding by doing the task with RN)....then of course date/time/sign.

Okay now we have to do this for ALL teaching!!!! Even if you teach someone about leaving their nasal canula in their nose!!! You have to document the risks/benifits, a little A/P, and patients understanding and if there are learning barriers you have to describe them all and your interventions!!!!!!! UHGGGGGGGGGGGGGGG!

NOW...they are saying don't do any of this!!!!!! Okay??? Well, I guess due to medicares new standards on hospital responsiblity...you have to not only document all of the above for ANY teaching...but provide the materials used according to protocol number or print out to explain ALL the risks/benifits and possible complications!!!!! Like saying I taught someone to use a pillow at their diaphram to help with sore ribs...well I have to provide education material authorized, or quote the number of the protocol and make sure I add things like "if you break your ribs during this...", or "if your cough doesn't subside by this time, you must....", or risk of infection from using this pillow for this then using it on your head.... etc!

Now we are simply shutting up and not giving good nursing implentations due to too much paperwork, or just doing it and not listing it (which will never hold up in court without documentation...).

Okay...who thinks this is a total shot in the foot????? This is insaine and stupid!!!!!!! Thanks Medicare for making things oh that much harder on everyone!!!!!

[jessiern, BSN, RN]

I had a very intellegent patient the other day ask me how many patients I had that day. I told her 7. Her reply was "So, 7 patients for 12 hours=less than 2 hours per patient." She then added "And then you have to subtract from that 2 hours per patient the 4 hours required per patient to do worthless paperwork. So, You have -2 hours to spend in my room providing care". I promptly said "yep".

Her biggest concern was were I was hiding my foley because surely I didn't have time to go to the bathroom.

[oramar]

I had a very intellegent patient the other day ask me how many patients I had that day. I told her 7. Her reply was "So, 7 patients for 12 hours=less than 2 hours per patient." She then added "And then you have to subtract from that 2 hours per patient the 4 hours required per patient to do worthless paperwork. So, You have -2 hours to spend in my room providing care". I promptly said "yep".

Her biggest concern was were I was hiding my foley because surely I didn't have time to go to the bathroom.

This is a good example of how some patients understand what is going on with staffing. Yes there are a lot of PIAs but for every PIA there are three patients that are loath to ask for anything because "the nurse is so busy". Even to the point where it could affect outcomes.:typing

[Antikigirl, ASN, RN]

LOL!!!! I like that patient...good common sense thought there! My patients don't seem to care how many I have or their accuity levels...they are my "only patient" in their minds...and especially their family's minds...LOL! (for these patients I watch them carefully for the whole "don't want to bother the nurse" deal...they could simply not call and fall or something...but like the common sense thing!).

Anywhooooooo....

What if I taught someone how to use the call light??? Do I have to go through all the stuff about electrical shock if they put it in water? Chocking on the cord? Not to eat or chew on the wires? having it fall on the floor and hurt their foot? LOL!!!!!!! This is crazy!

Think about how many dangers we nurses can come up with for something as simple as using a plastic med cup!!! LOL...oh watch out...you may cut your lip or fingers, you may choke, you may dump a valuable med, you may trip over it if it falls, you may dump your hot coffee when you accientally place it on the cup....LOL!!!!!! Let me get you the print out...ROFLMtooshieO

[jessiern, BSN, RN]

Think about how many dangers we nurses can come up with for something as simple as using a plastic med cup!!! LOL...oh watch out...you may cut your lip or fingers, you may choke, you may dump a valuable med, you may trip over it if it falls, you may dump your hot coffee when you accientally place it on the cup....LOL!!!!!! Let me get you the print out...ROFLMtooshieO

Careful...your gonna cause high level of anxiety with that patient.

[Antikigirl, ASN, RN]

Holly cow, not only anxiety but think about it...that nurse/patient relationship will be down to zero by having to give all this info and documentation because frankly...as a patient...I would feel that the RN thought I was an idiot!!!!!

Crazy stuff Crazy stuff. I am going to do as I have always done...nursing notes to document what I have done in simple terms. If medicare doesn't pay for it...Frankly...that doesn't seem to be in my department to fix...I will do what is asked of me till it is unreasonable or unsafe to my patients...after that it is beyond my reasonable scope .

[jjjoy, LPN]

What if I taught someone how to use the call light??? Do I have to go through all the stuff about electrical shock if they put it in water? Chocking on the cord? Not to eat or chew on the wires? having it fall on the floor and hurt their foot? LOL!!!!!!! This is crazy!

not eat or chew on the wires.... you made my day!!! :chuckle:monkeydance::roll

[DebRN06]

What if I taught someone how to use the call light??? Do I have to go through all the stuff about electrical shock if they put it in water? Chocking on the cord? Not to eat or chew on the wires? having it fall on the floor and hurt their foot?

:lol2: That was great!!