Monday, August 22, 2011

This is a long one, but this is my last opportunity to comment on a local memo, before I head down the road.

Nursing - What the Hell


I’m thinking of instituting a new Blog / Forum titled:
“Nursing – What The Hell?”

Don’t get me wrong, we nurses keep the world turning, but golly-gee, our leaders have the craziest ideas.

For example, the hot topic on the Staff-bathroom wall is the memo that includes the following paragraphs, outlining the latest “What the hell” idea; read along, and see if you agree. I have made special comments, as denoted by the asterisks.

Quote: “As we continue to provide the best care for our patients, we must improve our documentation accordingly. H, D & L(******6) reviewed what was taught to the nursing staff regarding documentation of patient turns. We feel that documenting every shift that the patient was turned every two hours is inadequate. We would like for all of you to begin documenting the individual turns that are being made. For instance, if at 8am, you turn the patient to the right, you will need to document in the I-view, that the patient was turned to the right and so on…..

”We appreciate the care that you give our patients every day.(*1) We want to be able to acknowledge that care, by having you document it in the medical record.(**2) The nursing department managers will be auditing your charting and coaching you as needed.(***3) The data gathered in these audits will be reported back to you, as well as being presented to the hospital leadership team.(****4) It is our desire to see the documentation of patient turns to reach the 100% goal."(*****5) Closed-Quote.

1* This is the sweet, feel-good stroke, before we’re slammed with the message

2** How exactly do they “acknowledge” our care, when we are documenting something? That doesn’t make a lick of sense.

3*** Now we’re going to be audited (to make sure we behave) and coach us if necessary. Oh boy, I love coaching! Perhaps it will be like my High School PE teacher screaming four-letter words during football practice. “Turn the G-D patient, you f**khead, or else I'm going to give you a jalapeno enema!”

4**** Oh boy #2, audit us and then tell the hospital leadership team; maybe they can coach us also.

5***** Look, if you want 100% compliance, we can all continue to lie about it in our charting (as usual).

6****** H, D & L = Huey, Duey and Luey.

It makes me laugh, how our whole frickin' management society in this country, want “100%” compliance. Nothing in nature will ever achieve 100% compliance. How about that cardiogenic-shock patient that will die if we turn him; the morbidly obese patient that fills the bed, and can not be turned; the need for three or four nurses to be available to turn a patient, when there are no nursing assistants;
the patient that wiggles out of position within five minutes of just turning them; and so on. This directive is ludicrous.

There is a severe nursing shortage in America (if one believes the media) and for some reason management doesn't get a clue: we, your valuable, and supposedly appreciated assets, do not feel happy when we are threatened with “audits and coaching, to achieve compliance”.

It all comes down to one thing, you know you are truly valued and appreciated, when the Capo di tutti capi are threatening you. Booyah!

Fibril_late;
8/22/11
* * * * * * * *

When I posted my pseudo-flier on the wall in the Staff-bathroom (see flier below), some persons actually thought it was true, until they noticed the silly poem at the bottom. Ain't that something? We are so inured (hardened, accustomed) by these types of directives, as to be accepting anything (no matter how ludicrous) that comes our way. That must be the sign of a "true" professional.

Breaking News! Breaking News!

From the

Breaking News Department

Beginning September 1st:

Q2 Turns will require a Witness

And,

Coming soon!!!

XOXO Hospital, is opening a new RN position

Finally, at last;

Witness Nurse

Now, let’s all sing together:

Turn them to the left
Turn them to the right,
Turn ’em supine,
And say, nighty-night.

Turn them around
Forward and back,
Get a witness while you’re at it
It’s the Q2-turn attack,

(Repeat)

Turn to the left
Turn to the right,
Stand up, sit down
Fight, fight, fight,
Turn them on their side
Thirty degrees, on the angle,
Have a witness to prove it
It’s the latest fandangle.

Fibril_late;
8/22/11

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