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HIPAApotamous! February 29, 2008

Posted by 5 Wester in General Announcements.
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I came in today looking for the familiar green clipboards that we carry around with our patient’s medication and vital signs flow sheet. Instead I was handed a flimsy white binder with pretty graphics on the cover that made me feel like I was in a pediatric ward. How dandy.

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I asked around and found out that the white binders are supposed to be more “HIPAA compliant”. “How?” I asked. “You have to keep them closed and not folded.” said one of the nurses… “It says right there on the cover”. Wow, that’s original. I don’t see why we can’t do the same thing with the old green clipboards. In fact, these clipboards work perfectly.

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First of all, it is sturdy and can take the abuse of nurses tossing it around, or like when it drops to the floor. Secondly it is not as bulky to carry than the 1/2 inch white binders that replaced it. This is yet another example of “if it ain’t broke don’t fix it!”

Instead of spending time and money creating these dandy works of art, the powers that be would have better spent their time and money encouraging nurses to keep their clipboards closed and out of plain sight if it was a HIPAA concern. Seems like they would rather spend their resources to frustrate the nurses into using white artistic binders which need twice the desk space to use, not to mention the increased total cost of ownership since eventually these binders are going to give out and you’ll have to purchase new ones.

If it was HIPAA they are concerned with, I’d focus my attention on the portable laptop computers used by nurses in the hallways.

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I’ve mentioned this to them before and even suggested the use of those privacy screens that allow you to view the monitor when sitting directly in front of it but blurs it when viewed from the side. However, like most “potential problems” they would rather have JCAHO write them up instead of taking a proactive approach. Well, what can I say… I just work here, right? 😐

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Redundant redundancy February 18, 2008

Posted by 5 Wester in General Announcements.
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flowsmall.jpgAs I gathered my things after giving report, my director approached me and gave me “the look”. She say, “I need to talk to you, step this way.” I obliged. I hope this doesn’t take  more than a minute, I thought to myself, I’d hate her to call me in again for “incremental overtime.”

“Quality control tells me you don’t enter your vital signs and I/Os in the computer. You need to enter them because they can see it at QA.”, she says. “Oh, ok.”, I replied just so I can leave. On my way home I’m thinking, why do we have to record vital signs on a paper form every hour, and enter vitals in the computer as well? Why do we have to be redundantly reduntant? As far as I know, redundancy just opens you up for errors. Besides, electronic medical records should make your work easier, not burdensome. Unfortunately for us, the interface development team at OPUS managed to inflict more pain in the newly redesigned vital signs flowsheet form. Yet another case of, “If it ain’t broken, don’t fix it!”opusflows1.jpg

How do you boil a live frog? February 15, 2008

Posted by 5 Wester in General Announcements.
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I’m sure you’ve encountered this question before. At first it didn’t make any sense to me. Who in their right mind would like to boil a live frog? Then the lesson became clear when I found out how they do it. You don’t just throw a frog into boiling water. You actually put the frog in the water first, then bring the water to a boil. The poor thing will sit there, relaxed, in his hot tub of death. As graphic as this may sound you wouldn’t believe me if I said that this sort of thing happens in our hospitals today… at least where I work it does.

You see, it has something to do with the new “matrix”. Management in their ultimate wisdom decided that ICU nurses are able to handle 3 patients instead of the usual 2. Now instead of having something that’s manageable as a 2 to 1 nurse patient ratio in the ICU, you have to play catch up with all your charting, med pass, nurses’ notes, etc., not to mention the other stuff that pop up here and there like constantly following up with the pharmacy to get you medications you ordered 4 hours ago, and to top it all off, you have a documentation system called OPUS that’s worth doodly squat! Eventually they figured that nurses will “get used to” 3 patients… then when you “warmed up” to the idea and your patient load threshold has been raised, one day you’ll find yourself with 4 patients… in the ICU mind you! 

Have you ever wondered who came up with the term “nurse burnout?” Makes me wonder if there is a relation between nurse burnout and the nursing shortage. Most studies I see try to correlate patient satisfaction with nurse burnout, however, I haven’t seen any studies done on nurses’ job satisfaction and increased turnover in relation to increased patient load, or other factors as silly as cheap gloves or inadequate supplies. I’d like to see a study that focuses on nurses’ needs for a change.

Yes, you can give nurses advice on how to “take care of yourself”, or how to prevent “burnout”, etc., etc. I’d like to see suggestions on how to improve nurses’ lives in terms of what we can do to make nursing less stressful, less frustrating, less burdensome. How? By creating a work environment conducive to more efficient work flow through simple strategies and common sense. For once, involve nurses before creating policies that seem to defy the laws of logic. They’re in the trenches, they know what will make their lives (and their patient’s lives) a little better, more bearable, more manageable. Otherwise, we can only see a downward spiral that could reach critical mass in the next 10-15 years.

Johnson & Johnson in their quest to reignite the passion for nursing has listed three good reasons to be a nurse in their website discovernursing.com. I can think of more reasons why not to be a nurse based on what is really going on in the healthcare industry. I just don’t understand why we as nurses cannot band together and form a national nurses’ union to impact the healthcare delivery system. After all, we are health care, and we are the ones who deliver it. Unfortunately we are under the “servant role” instead of the “master role”. We are expected to bend over and take it up where the sun don’t shine! I think enough is enough. Do you think a 3 to 1 nurse patient ratio in the ICU is acceptable? I’d like to see hospital management as a patient one day… hmmm maybe they’ll get the quality care they deserve. What do you think?

Death and Taxes February 7, 2008

Posted by 5 Wester in General Announcements.
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What? It’s that time of the year again!

Time sure flies when you’re having fun. I guess we get too busy sometimes that we tend to set aside the other things in life, like blogging. January has been a crazy month. One day you celebrate the New Years, the next day, it’s almost Valentines. In between you get your W-2 and think about all the nice stuff you’ll buy when you get back what Uncle Sam has “borrowed” from you throughout the year… of course without the interest. Unfortunately we can’t charge Uncle Sam finance fees. It would be nice though… imagine 25% APR on your tax return. Dream on! 😦

Well, I’m sure you’ve heard this saying before… “there’s nothing more certain in this world than death and taxes”. Whoever coined this phrase was just oozing with optimism. Not! I’d hate to be his friend. Nevertheless, most of us may be feeling this way, especially with how things are going on in our government and economy these days. Are we or are we not in a recession yet? Who is going to be the next president? What did I eat for dinner that’s giving me gas? These are trying times my friend, and the future seem to be uncertain… unclear. However, regardless of the uncertainty, I’m glad to know that despite all these things, God is still in control. How do I know? The Bible tells me so. (Psalm 95:1)