since we went to the EMR I have come to abhor the 'big bag o' med's.' While I have never understood why some people have so many medications, and even writing it down was very time consuming, prior to the EMR we could just copy 'the list.' Now, with the supposedly time-saving and efficiency improving EMR (not!) has become a tedious, laborious, time-consuming task. And to make it even better, our computer medication reconciliation is not acceptable for an admitted patient, they require the special form so once a patient is admitted we must re-write the WHOLE DAMN THING!!!!!!
ARRRRGGGGHHHHHH!!!!!
I only have one request, could someone with a TEENY, TINY bit of common sense make the rules?
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- ERnursey
- A hardworking ER nurse trying to survive until retirement and if I can have little fun or have a positive impact on someone's life, all the better!
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4 comments:
When we started our EMR, we had to enter a reason in for each medication. If the patient was admitted and the reasons were not entered, the whole med list had to be re-entered with reasons. If the patient didn't know the reasons, the doctors would have to re-enter them with reasons.
Finally, we stopped having to do reasons for every patient, just those being admitted to the nursing home for the first time from the floor. Whew, thank God.
Anyway, it blows when you first get the EMR, but on the patients' repeat visits, the meds will be in there for you and you'll just have to click them. Clinic doctors keep the lists reasonably updated too, assuming your hospital system's clinics have the same EMRs.
I was doing a psych assessment in the ER one day on a woman who came in with suicidal thoughts. Anyway, part of the assessment requires that I enter what medications (including dosages, how many times a day taken, etc) the patient takes. So I get to the question about what medication she is on and her husband (who had been holding a duffel bag the whole time, which I assumed was because she assumed she would be admitted) handed me the duffel bag and said her meds are in here. I opened up the bag and seriously, there were 15+ meds in there. That was a pain in the (pick the body region of choice) to enter in the computer. I seriously spent more time entering medications in that one question than I did on the rest of the assessment.
They will not require common sense, because that would discriminate against people who don't know how to make rules, because they are only good at making stupid rules.
*sigh* Med Reconciliation is a pain in my arse. In our facility, we need a brand new med list on admit, with reasons for each drug, one for each transfer within hospital (meaning, off to the ICU? new med list for you. surgery? New med list on return from PACU), and a brand new entry for discharge.
It used to be ok if we didn't get the information right away, because those lovely folks in the ER got it for us... but now with their brand new charting system, we are seeing more and more of -drug name, -drug name, -drug name with no dose or reason.
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