Does anybody rememer when an actual registered nurse ran the Central Supply department?
I don’t remember if I was assigned or if I requested it, but we had one whole day to shadow a nurse in a specialty, back in college.
What a cushy job! Put trays together, run the autoclave, make sure the floors had what they needed in terms of sterile equipment…no patient contact!
At least that is what I thought at the time.
I’m sure it had its pressures, but why on earth would you need an RN to run Central Supply?
I can’t imagine that is done anywhere anymore, but I’m interested to know if you know of any exceptions!
The saga of Blogger T. Squirrel continues.
His mom and sibling showed up this morning to partake of the Squirrel Chow, so I guess the whole family has adopted the back yard as their territory!
It will take more than seven cats and two dogs to scare this intrepid group of rowdy rodents!
I’m not perfect.
I’ll wait a moment for the shock of that statement to subside.
But, work wants perfection. No, Joint Commission wants perfection which means work wants perfection which means I am expected to be perfect.
You know what they say “runs downhill”.
There is one small problem.
I can’t be perfect.
I chart neatly enough to consider framing it. I was one of the first nurses to actually complete entire medication reconciliation reports even as I mentally screamed in frustration over more paperwork. The nurses on the floors know who I am by the quality of the written reports I fax upstairs. My patients are happy with their care and I work well with all the doctors.
I do the best I can every single shift; I try to meet every single requirement, dot every “i” and cross every “t” and document my ass off so that administration is happy. I run my ass off to make sure that my patients are well cared for so that they are happy (and safe!). I do everything for everybody and all I get in return is…
Notices of what I didn’t do.
Every registered nurse in the facility gets a letter from the hospital administrator delivered to their home decrying the state of compliance with the fifty million minute Joint Commission requirements for documentation. Guess that mock survey didn’t go so well when it came to the paper trail.
The one chart of mine that gets audited doesn’t have the medication reconciliation record signed, and so I am listed as “not meeting the standard.” I have no idea which chart. For all I know, it was a three page record and I forgot to sign page number three. But, I “don’t meet the standard”.
The hell I don’t!
It’s not just the patient documentation we get dinged on. It’s how we have to chart to get paid.
Here’s an example. I had a critical patient who was going to surgery any minute; the surgeon was at the bedside. I’m flying to finish the documentation and get him ready to go when a patient walks in who is having either an heart attack or a pulmonary embolism – who knows? He looks sick. The department is full, no one else is available to bring this patient to a room, so I stop the surgery paperwork and quickly get the new patient on a monitor, EKG’d and put in an IV.
I run back out just in time to finish putting the paperwork for the surgical patient together and off he goes! Back to the MI/PE patient I go to finish my assessment, when I realize I did not put the “stop time” of the surgical patients IV antibiotic on the chart – it had finished as he was being transported out the door.
We won’t get paid for that IV. Never mind I charted it under the “med” section. Never mind that I charted it under the IV section. Never mind that it is in the narrative, also. There is no “stop” time on the chart.
So we won’t get paid.
If we put in an IV, begin a saline bolus, push Zofran and Morphine for pain and then hang an antibiotic via IV piggy-back, we MUST chart the IV push meds as the initial charge. Not the bolus for hydration. That is secondary, as is the piggy back IV.
Or we don’t get reimbursed.
Yes, we have to remember inane details like that. What the hell has it got to do with nursing care?
- Tired of jumping through regulatory hoops.
- Tired of being bombarded with minutiae.
- Tired of working my butt off only to get “dinged” as “not meeting the standard” because of one signature.
- Tired of charting for reimbursement instead of focusing on the patient.
But you see, no one cares.
Oh, they care about Joint Commission. They care about how you chart your IVs and the order in which you charge for them. They care that you put a number on the pain scale and repeat it after a medication is given. They care that you count the narcotics even though you have a computerized medication dispensing system that should do it for you. They care about anything and everything except the nurses actually doing the care.
They want us to be perfect and I am not perfect.
Guess that means that I “don’t meet the standard.”