WHY??

1 Hi everyone! My unit was just told that starting next week our pt assignmt will not be posted until 5 min until shift starts...there are some nurses including myself that arrive to work early..on our time(not clocking in early) to look at our kardexs and prepare our brian sheets...we are not doing anything except looking at kardexs in the report room, it helps us all feel alittle more prepared for our day and more prepared to take report..according to our supervisor, she said that our legal departmt is sayin its a "legal issue" and they will no longer allow staff to come in early as we have done for yrs. I dont understand why this is a legal issue? We are no doing any pt care..doing nothing but looking at the kardexs...and we are not asking to be paid...does anyone know why this would be a legal issue? I really need the extra time to feel prepared..it has been my routine since i started 2 yrs ago i am very upset about this and just do not understand why it would all of a sudden be an issue?? I could understand if we were asking to be paid for the time or jumping in and doing pt care..we dont even anwser the phones??! Does anyone understand this? Ive talked with my supervisor and explained to her that I really need that time..she says its not her, its our legal departmt. If anyone has any suggestions as to how I can keep my routine I would greatly apprecated!!! I do it for myself and Im not and would never expect to be paid for this time.
My unit cracked down on that a while back as well but nothing was said about the legal dept initially. We were told it was about OT and people weren't to be clocking in until 5 minutes before the shift started. Some people continued to come early but not clock in for the same reasons you cited but we were told we couldn't do that either. Apparently, it's considered working off the clock and arguments that it wasn't (as it was just reviewing patient info) were met with it being a violation since if we weren't on the clock we didn't legally have a right to access that info.

I'm sorry; that sucks. It probably has less to do with the fact that you're coming in early unpaid, and more because you're viewing medical records before you've clocked in and accepted the assignment.

Under labor law employers are responsible to pay you for any time worked. Hospitals are being looked at more than in the past due to complaints from staff working through lunch, staying late to finish charting, etc. and not being paid. Even though you are not asking to be paid, what you are doing may be considered to be working and therefore the hospital has to pay you for that time.

I guess you might be not be ready to get report from the offgoing nurse until later than before. You still have to get all the info you need. I am always there early too. So far no problem at my work.

Have you contacted risk management or the legal dept. for an answer? Go right "to the horse's mouth."

This is not a situation unique to healthcare. It opens the hospital up to potential liability if someone were to report that nurses are consistantly doing work related tasks while not on the clock. Believe me, the hospital would rather you be more efficient, however, their gain is minimal compared to the potential liability.

Our hospital has gone the same way, and, yes, it stinks. I used to come in early (on my own dime) to get organized for my shift, but we aren't allowed to do that anymore. Now, I have to fill out my time grid and listen to report in a much quicker time. I have found, that it is doable, but I'm probably now having to cut into about 20 minutes of patient-care time. Also, think about re-doing your time grid/brain sheet, and using different colored highlighters. For each cell on my time grid, I just highlight in the coded color the things that apply (I have them printed out, and if not highlighted, doesn't apply). Highlighting takes less time than having to write something out. I hope that helps you out.

Quote from scoochyHave you contacted risk management or the legal dept. for an answer? Go right "to the horse's mouth."

The 'legal' issues also involve your personal safety. If you were in too early and got hurt on hospital property there might be worker's comp issues.There are all sorts of reasons why they don't want you there; ask them for their exact reasons.

We never find out our assignments until after group report. We're busy enough, as it is, no way would I want to start work before the start of the shift.

And thats fine if you dont want to come in any earlier..whatever works for you..but for me and some others the way it works best for us is to come in prior to our report to prepare. I work on a med-surg renal/vasc/urology floor, we all get 6 sometimes 7 pts..our pts are very sick..having that kind of ratio is another ongoing issue on our unit..its so unsafe. Many of the docs think we are a step-down unit or think we should be. We have a taped report..we are expected to listen to the taped report on our assignment as well as the other pts on our hall while we are writing and reading info from the kardexs. The taped report is important..lots of info that we need..I can not listen, write and read at the same time..its just way to confusing! Our kardexs have a ton of info that we need at our finger tips to care for our pts that we have to put on our brain sheeets (IVF, drsg chg info, CAPD solutions/schedules, DRs, Hx, Dx, Pending/scheduled tests, procedures, labs, FR, any restrictions, ect ect) ..I have always come in early, on my dime, to add that info to my sheet that I need to take better care of my pts which then I feel even more prepared and focused to actually listen to the taped report. I think our jobs are tough enough without this added problem. We are expected to know and do everything..yet it seems like a road block is always put up making things even tougher! Im not on the clock, Im not asking to be paid, I am a nurse that will care for the pts for that day so who cares if I get the info from the kardex beore 0645, Im not going to share pts info just bc I have my assignmt early, Im not looking to get hurt for a WC claim..I just want time to prepare for my day..the way that works best for me, the way that makes me feel prepared to give the best care I can..why doesnt that matter anymore? With 6-7 pts I dont have any extra time to keep going back to the chart to check things..some pts need vitals q 1hr. q4 or q8, BS cks are different, everyone has different FR, IVF, dressing change times/solutions, we do CAPD at the bedside..sometimes the solution chages every other exchg, we have fistula and neuro cks that are ordered differently for each pt..ect, ect. I'm just so frustrated with this and ****** that this is now after 2 yrs such a huge problem!Thanks everyone for your comments and suggestions.

Taped report is an absolute waste of time on both ends, never mind it is in direct conflict with jcaho published hand-off procedure guidlines.A nurse needs no time to prepare. (That's school nonsense) A nurse needs ABC's, and prioritization skills.A victim who collapses before you comes with no kardex, no history, and no care plan. "Safe Nursing Practice" does not come with planning, it comes with prioritization.