Nursing is Hard

florenceYou can’t go into this thinking you are going to bring peace and comfort to patients and their families in their times of great crisis. You must shed your image of you coasting silently through the unit in dim light bringing healing to the ill, solace to the dying and wisdom of your experience to the new nurses.

You are going to have to work.  And you are going to have to document that work. Every, Single. Day.

I had the unpleasant task of sitting down with a nurse of over 20 years last night and showing her where her documentation was deficient. Now granted, the switch from paper to electronic can be a struggle, but that happened over 5 years ago and so should be nailed down. As an experienced nurse in an area where assessment is king, I would expect that understanding to be represented in the documentation.  If you did it when you were paper documenting, why would you think you could omit parts when you went to electronic?

Patient after patient the documentary followed the same pattern – it was like she disappeared every night between 0030 and 0200 and reappeared at 0500. How can you possibly remember what the 2100 urine output was at 0530?  How can you possibly expect anyone to believe that you remember the vital signs each hour as correct 6 hours later?  There is a reason block charting is not an acceptable norm in specialized areas where you have 1 or 2 patients to care for, and it has to do with you being present in the patient’s environment all shift long.  There is an understanding that in a rapidly changing environment where patient condition fluctuates the nurse is expected to be able to document those fluctuations when they occur.  If you cannot manage to do that for each patient, perhaps you should be in another area of care.

I am stumped at how a whole shift can pass without a single thing being documented.

And yes, I am peeved that every time  there is a conversation about something you need to do differently you cry and blame it on someone else. I can see emotional manipulation a mile away.

Grow learn change. You are the professional, You are responsible for the actions you take. We all are, me included

Of course in an union environment there is not impetus to be accountable and responsible.  The union will stand with you to demand that you didn’t get the correct education/training/opportunity/etc so how could you possibly be expected to do your job correctly. So why is it that other people can meet the standards?  Were they given special treatment you did not receive? I suppose that is where this is going.

Nurses want to be seen as professionals yet they continue to be represented by unions that indicate they are not professionals but rather downtrodden workers in need of protection. Make a choice.