I was working away the other day and my boss came up to me and says: "we want you to stop charting that you tried to give report and the nurse was unavailable."
WTF? So I ask why and she tells me that the quality people don't like it as they feel it makes the floors look like they are delaying care.
Um. Isn't that what they are doing? If it takes me an hour and a half to give report and get the patient up to the room after I have received a room assignment then I for DAMN SURE am going to chart why unless you are asking me to falsify documentation.
"Well no, I'm not asking you to do that. Perhaps you could make it more generic then - for instance 'attempted to call report, nurse not available.' (I suspect this came from a chart where I tried to call report for close to two hours and got every excuse under the book: the nurse was at lunch and the break nurse was unavailable, the charge nurse was off the floor. Now the nurse is back and is in an isolation room. Now the nurse just got a post-op and the charge nurse is in an isolation room. Now I paged the nursing supervisor to clarify the issue with the floor and she didn't call back until after the fourth page. And so on.)
I told my boss that I take great pains with my documentation and I am not going to 'fluff' it. She was not happy. There are many days when I am sure she wonders why she took her position. Such as that one.
Wednesday, February 20, 2008
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13 comments:
Wow, I don't know where you work, but as a former floor nurse I would have been ecstatic if I was able to enjoy my lunch without being interrupted to take report. Our pagers were constantly going off during lunch break and we didn't have the luxury of denying to take a call whether for report, giving pain meds, or surgery has called and pt has to be ready for pickup. Hmmm, must be nice.
Good for you for standing up to your manager-person. I recently had to do the same thing, regarding how I chart when an MD reviews a FHR strip.
Cover your butt - maybe things will change if you chart it enough times!
Keep charting ALL your attempts - EACH time you call! Maybe, just maybe, it'll show someone in the admini-nation where some of the problems are....
How 'bout doing it this way:
"Busted my butt to take care of patient, including room assignment verified. Multiple attempts to ensure continuous, appropriate patient care obstructed by repeated lack of anyone to take report. Patient care continued in ER."
:-)
I like that one medic, I like it a lot.
Odd, we're encouraged to chart when the floor didn't take report.
I try the nurse x 2 and then immediately after the 2nd attempt, I call the charge nurse of the floor. If the charge nurse/patient's "break buddy" won't take report, then I call the nursing supervisor. I don't put up with that crap for very long. If the nursing supervisor is calling asking why they are not taking report when they just said the bed was ready, USUALLY, they call down for report in a few minutes.
My only exception is a recent or current code on the floor, then I give them a few courtesy minutes.
Unless its a peds or ICU patient, we FAX a report, confirm the fax was received (which prints on our fax machine) and haul the patient up. Sure speeds things up.
Ahhh, yes. That brings back memories. Same old crap happens in the UK. The ones that made my BP raise the most were:
"The Nurse is just having her break". When we'd worked a 12 hr shift and not had so much as a glass of water.
or:
"I'm sorry the beds STILL not made". I have been known to go and make the bed myself with a porter. On one occasion as night the bed didn't have a matress as the nurse was sleeping on it in the staff room...Not for bloody long though!
Arrrrrg!
Yeah, we fax report to the floors. We give verbal report to any of the ICUs and the stroke unit.
If a bed isn't clean (or if for some reason there's no actual bed in the room--has happened recently) and we're experiencing a patient surge, we have the transporters take the patients up in the stretcher and leave them at the bedside. (For stable patients who don't need 02 of course!)
Tell her that if you wanted to work as a fluffer, you'd get a job in porn (look it up if you don't know what I'm talking about...or on second thought, maybe don't).
LOL fluff and buff....
I used to do that with patients until I learned the alternate meaning.
ER Nursey,
How do you extend your post to fit the entire page? Mine sits right in the center with blank spaces on both sides. Help?
Anne, unfortunately I know what a fluffer is LOL
Talk i pedic I used a different blogger template is all.
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