Ive just about had it. Rant and I never rant.

34 Ive been a nurse for 7 years, almost 8.. Before that I was a CNA for 3 years. IVe worked med/surg, tele, been a float nurse, done agency, and now I work in an icu. Ive worked at a multitude of facilites and dealt with all kinds of charting.

Before nursing I obtained an associates in computer information systems, was an A+ certified computer tech, and was well on my way to obtaining my microsoft network engineering certificate.

I know my way around a charting system, and I know my way around computers.... But I see a trend. And I dont like it.

More and more it seems like people who have absolutly no concept or background in bedside nursing are creating programs and dictating charting on us who live, breath and sweat bedside nursing. either that or they worked bedside in the days of 20 patients and blanket warmers for blood.

Im also seeing a "customer" approach to patient care, which is complete pc bullcrap. No customer in the world is allowed to spit, ****, assault, or cause chaos in any business in the world. No customer has the potential of dying at any moment in any business (except planes of course, but people dont fly planes because they are sick as hell)

Add this together and you have more and more charting taking away more and more from patient care.

We had a new system come online today in our hospital and I had an admission. Fairly stable, came to the icu for initial bipap support until lasix and antibiotics get her better.

It took me 2 and a half hours to do her admission assessment, and her regular assesment. If she was busy, it would of been a nightmare. Mind you... I know how to chart. This was a system problem. It should of taken me no more than a half hour.

I am finding more and more as time goes on, we have more and more charting added on to us... expectations that far exceed reality when it comes to charting.. especially in the presence where no overtime is allowed.

I am finding that I have to rush true nursing care like a bed bath, or repositioning a patient because of the amount of charting.

I love my job, but I can not see myself continueing as a bedside nurse much longer if this continues. I dont know how ethicaly I will beable to when my job is turning into 75% charting, 25% patient contact.


Im rambling now, Im tired, and I worked a 12 hour shift then went to the gym before venting this... but I am getting very frustrated with the way nursing is going.
You're absolutely right, it seems as though administrators/executives have a true talent at taking something as simple as charting nursing care and complicate the hell out of it. It's inefficient and a flat out waste of time for us to have to document one simple piece of data multiple times in multiple places, but sadly we don't make the rules. As I look at continuing my education I seriously question my future in nursing. Sadly, I've realized I have passion for what nursing SHOULD be not the "customer is always right" manic masquerade that nursing has turned into.

I think down the road Ill look into teaching. I know I will be doing tons of papers, but I think Ill actually enjoy that.I dont really look foward to seeing what nursing will be in 5 more years. Computers were susposed to make our life easier in medicine. It certainly has not. And this is coming from a computer geek.

My suggestion for you is to research and possibly find a job in nursing informatics. You have a computer background plus a nursing background. We need more people like you that recognize a problem and have the means and the brains to fix it.

Quote from mikeperkins_rni am finding more and more as time goes on, we have more and more charting added on to us... expectations that far exceed reality when it comes to charting.. especially in the presence where no overtime is allowed. i am finding that i have to [font="book antiqua"]rush true nursing care like a bed bath, or repositioning a patient because of the amount of charting.

Also think you should look at nursing informatics as a possible career change. Might be just what you need.

I agree. The constant changes to charting are definatly not made by a bedside nurse. For example, to chart a Heparin gtt, we have to chart each hour, date, type in the rate, time, 'infusing', ect. for each entry/hour. That's a lot of clicks for one hour. Multiply that by 12. Multiply that for each gtt. Then each med. then 6 patients. Then the flowsheets. the required pain note for EVERY pain med you give. Nuts.

Not to be devil's advocate here, but why would you suggest nursing informatics as a career choice for someone that simply wants to do more "true nursing care"? Being frustrated by computers because they take you away from the bedside is certainly not a good reason to commit more time to computers, away from the bedside. I agree that the computerization of nursing needs smart and talented professionals, but if someone has a serious dislike for the documentation aspects of nursing, going into that specifically seems like a bad choice.

Brother, I feel your pain and your frustration. I finished nursing school at 42 years of age. I have a bachelor degree in journalism and a master of education degree. Before becoming a nurse I had worked as a handicapped preschool teacher/coordinator and program coordinator for the dually diagnosed mentally ill/mentally retarded. I also worked as a state medical malpractice investigator. Having been around the block, I knew that as a new nurse, there was an awful lot that I didn't know and that I had so much to learn. Little did I know that once on the job, I would have a lot to teach other medical professionals. One thing in particular was pointing out the tremendous potential catastrophe one very large facility's computer charting was creating. For each of the body systems assessment fields, there were two or three data sets to choose from, and nurses were encouraged to select a data set and discouraged from "entering free text." Routinely three elements of a data set might be accurate but one or two elements might be inaccurate. This occurred frequently where the information on cardio and pulmonary systems assessments were charted and some of the data sets overlapped, but were contradictory. More often than not, I found it necessary to "free text" most of the assessments fields in order to document an accurate assessment. My preceptor (a very capable young lady with 6 years experience) was horrified by the length of time it was taking me ( the silvering haired recent nurse graduate) to chart. She called me down for being "too meticulous" with my charting. I showed her the problems on the system with the conflicting data sets. She blinked several times and said, "So, what's your point?"I pulled up a chart she had worked on and showed her how the data sets she had selected for the cardio and pulmonary assessment fields contradicted each other. I showed her how all but one element of each field was accurate. She said, "So, it doesn't really matter."I told her that she wouldn't feel that way if it was ever brought to her attention that she was providing inaccurate data for the patient's chart. I also explained that if she ever was called to deposition or to testify in court about her charting on a med mal case, she would be in a mell of a hess trying to explain why her charting had inaccurate elements in the assessment fields. I explained what it's like to see people squirm under sworn oath when it is suggested that perhaps all of their charting is suspect and not trustworthy. Sadly, I don't think she ever got the point. I did not stay at that facility very long because there were so many aspects of patient care and safety that were being routinely compromised. (I did make certain that I shared my concerns about the medical records with the IT folks before I left.) There were so very many very young nurses with five or six years experience, all at that facility. They lacked the life experience and work experience to see these issues as the serious disregard for patient safety and well being that they are. This is not intended to slight young adults and their nursing abilities in any way. It's just to say that when anyone is exposed to only one way or one protocol and it's all that they know, they may not realize that what they are doing is possibly incorrect, unsafe, or a breach in the standard of care. They can be jeopardizing their licenses and not even know it. I have also seen facilities with systems where you had to use separate computer programs to enter doctor's orders, CBG's, dietary requirements, and consult requests. None of the programs communicated with each other. What a huge drain of time, energy, and effort. Entirely too much time spent on "charting" leaving inadequate time for best practice nursing care to be implemented.

Quote from 2011nursetobeMy suggestion for you is to research and possibly find a job in nursing informatics.

I disagree Grace Thats the perfect person because as a bedside nurse t hat person would know what we need and as a "computer geek" would know how to cut out all the extra copies of the same forms, in a different order, for a different department, or whatever cockamamie system these so called professionals are coming up with!

Quote from noreenlI disagree Grace Thats the perfect person because as a bedside nurse t hat person would know what we need and as a "computer geek" would know how to cut out all the extra copies of the same forms, in a different order, for a different department, or whatever cockamamie system these so called professionals are coming up with!

Quote from noreenlI disagree Grace Thats the perfect person because as a bedside nurse t hat person would know what we need and as a "computer geek" would know how to cut out all the extra copies of the same forms, in a different order, for a different department, or whatever cockamamie system these so called professionals are coming up with!