Wednesday, March 25, 2009


I forgot to come back & report how it was the night we bought Twilight...ooops, sorry about that! There was a line....of about 50 or so people. It moved pretty fast once 12:01 came along. My niece is thrilled...I have yet to rewatch the movie. I am looking forward to the next one that will be in the theaters on Nov 21.

I had a decent week at work. The first two nights were relatively I knew last night something would have to go wrong. It was a bit hectic the first 4 hours of the shift....back to back discharges. I don't mind discharges, but I do mind all of the paperwork we now have to do just to discharge someone. I remember the days of where we would simply write "continue all home medications" & send the patient on their way. Nope, not any more. The Joint Commission of Healthcare now has us writing novels for each & every patient that leaves the hospital. I guarantee at least 90% of our patients either toss this mass of paperwork in the garbage or in a drawer...never to be seen or ever read.

One patient last night....22 pages of discharge information. We give them information on their diagnosis, their new medications, their follow-up appointments, etc. 22 pages. Come on! And this patient only had 4 new prescriptions. I can only imagine how many pages it will be for someone with 10 or more new prescriptions. I think it's kind of overkill...considering they will get information from the pharmacy when they have the prescription filled.

Luckily, I didn't get any admissions last night...just an ICU transfer. He was a sad case....cirrhosis of the liver from years & years of drinking. Now he has a huge cancerous mass in his liver & for some reason - they were talking about putting him on the liver transplant list. I didn't think that was possible due to the fact he abused alcohol for years. He is in miserable condition now & it's sad to see that. Most patients we have are in the hospital because they are non-compliant in some form or another. I am the same way...I don't eat healthy, I definitely don't exercise enough, I probably don't get enough sleep, etc.

I was watching on Oprah about how they are now coming up with ways that we could possibly live to 125 to 150 yrs old. What? Does anyone really want to live to be that old? Supposedly we'll still have the energy & strength of someone much younger...but who knows. I can't imagine it.

I injured myself Monday before going to work....I hit my little toe on a doorway. Ouch!!! It's all bruised. I'm not sure it's broken, but it sure is sore. It hurt to hobble around the last two days. So I'll be trying to rest it the next couple of days.

I was handed our employee handbook or JCAHO readiness book...whatever it's supposed to be & I looked at the names of our "executives" which is neatly placed at the beginning of this book (as if they are the most important people in this hospital - don't get me started!) All of them are new except our CEO. All of chief financial officer, new chief operations officer, new chief nursing officer. And even though we are unable to afford raises, bonuses, etc.....they have created a new position of chief of inpatient nursing officer. I guess it's safe to say that's who is getting our raises & bonuses...her salary. On top of that, the manager of our unit has resigned & left and now I just heard the assistant manager (or whatever her official job title was) has also resigned. This is scary to me..........all new people plus the fact that our managers have bailed completely. I can only imagine the change that will be coming our way now that we have no one to speak for us.

Sure there will be new managers...but will they have the guts to stand up for us when they are brand new in the position? I doubt it. They want to take away our breakroom & turn it back into a patient room so we can have additional patients. They will give us some small office to use as a breakroom.

I'm it like this everywhere else? Are there hospitals that are better? Or worse? Let me know!


Young said...

First I can't believe that you have to write a novel for a discharge patient. Although I know that you have lots of paperwork to do. i did have an experience when I became the headnurse for a week. Gosh! It will take a lot of time and effort to do and handle everything.

Where are you working right now? I'm not sure but about a year or two I met someone who works on John Hopkins and told me that if I want to work as a nurse, I should try New York. She mentioned a lot of places but I don't remember the others.

Wait, they are putting the patient on the list even though he drinks alcohol a lot. Why? I thought there are boards who discussed who are the patients who deserves to be put in the list? Am I wrong. Sorry I am curious about the changes concerning legal matters now.

It's not that I want the patient to die but if gets a new liver, will he stop drinking alcohol for good? He should.

Pamela said...

I used to HATE all of the paperwork! The one that got me was the Medication Reconcilliation Form that must be filled out prior to any transfer...or discharge. UGH! So much work!
It's all about covering your butt, though. The hospitals butt, too! Problem is, there's so much paperwork that there is bound to be mistakes. It's crazy.
I worked in hospitals where the management teams were pretty stable. I was lucky in that respect. My job now isn't like that. My current supervisor will be leaving as soon as she finds a job she likes. Sad. I'm so bummed. There are a lot of issues here with management.
I just keep my nose down and do my work, yanno?
Good luck! Pam

Amanda said...

That is insane that discharges are so long! Ours are two pages MAX-with just alist of the meds and dosage instructions. Or it will just say "Resume taking all medications that you were taking prior to hospitalization." The end.

Temple is going through some changes too. New upper management, no overtime, budget cuts... This is a contract year and I am pretty sure it will go to an actual strike!

Julie said...

Our management changes so often I gave up trying to remember their names. And the paperwork these days, ridiculous. All to cover your butt, but if you had less paperwork you could do more bedside nursing. All regulated by people who have never worked at the bedside. don't get me started on the joint commission or state. If all the managers and CEO's missed a month the hospital would run just like clockwork, if all the staff called in they would have to close the place. Hope your toe feels better.