[lam]

I have also heard management tell nurses to copy what the day shift wrote. yes charting is done, but how accurate is it? these are the people that give nursing a bad name. The reason for the skilled charting is to assess the resident for your shift and then chart accordingly. So how the heck can you chart in the beginning of the shift? But that is exactly what is being done. How do you prove this? You don't because you end up in the situation that I am in if you do. and if you are the one doing it the right way everything doesn't get done. Then you are the one that gets in trouble, because management either doesn't care or are clueless.

[cassioo]

you see that coping charting everywhere. I see staples CDI then you look and it's sutures because most of the time our docs use staples so someone assumes and never looks and the next does the same. Or charts incision CDI but the dressing is still on...how do you know what the incision is with a dressing on it? Or skin intact and you find some decub that is far enough it didn't start in the last 8 hours when it's already got necrosis. Everybody needs to do head to toe when you should chart what you do when you do it, let the doc, management know when there is something they need to know and chart what you did, write it up. If everyone would play nice it would be a much better place... isn't that how it should be in your whole life anyway?

[lam]

It was so bad in one place I worked that I would have spent the whole 8 hrs writing people up. these CNA's were rough and one actually threatened me. I don't need that crap.

[nursinghumor]

I've worked in both acute care and long term care and I stand by my statement. The frequent corners cut by long term care nurses fall into my definition of "bad habits" and hospital nurse managers tend to agree when deciding who hire.

When do you cross the line into where falsifying records is illegal vs unethical? The line becomes blurry when you're given an impossible workload.

Andrew Lopez, RN
http://www.nursinga2z.com

[lam]

Sorry but like I said before bad habits? do you mean cutting corners by assessing what is a real nursing function as apposed to doing things to passify management who has over compensated for the state regs. Or are you refering to charting facts as apposed to page long notes done to impress and have no more power than to hide the actual data? Because when I go to suction some one I do it the same way that it would be done in the hospital unless a resident prefers it done another way and this is charted. Please be a little more specific with what you consider to be bad habits. a habit is something that is done repeatedly and is difficult to change. As far as I know there really are no instances in LTC where you would be doing the same thing over and over to the point of becoming a bad habit. Falsifying is fraud and that makes it illegal. Ethics is a whole different ballgame. and what do you call it when hospitals send our patients back to us with stage IV decubes. Give me a break.

[nursinghumor]

[ QUOTE ]
lam said:what do you call it when hospitals send our patients back to us with stage IV decubes. Give me a break.

[/ QUOTE ]

The same thing as when a patient who started with no decubiti ends up with a stage IV and is sent to the hospital after they go septic.

Andrew Lopez, RN
http://www.nursinga2z.com

[lam]

you mean the one that came from the hospital in the first place. My point is nursing is nursing. and to use what you are claiming as a criteria for hiring a nurse is silly. you can keep your views/opinions, but it is that attitude that is keeping some good nurses from working.

how about when the hospital sends a patient back to us who is septic and we have to turn around and send them right back because the hospital didn't recognize that the pt. was septic in the first place. lol we can go back and forth like this for ever.

[nursinghumor]

[ QUOTE ]
lam said:
you mean the one that came from the hospital in the first place. My point is nursing is nursing. and to use what you are claiming as a criteria for hiring a nurse is silly. you can keep your views/opinions, but it is that attitude that is keeping some good nurses from working.

[/ QUOTE ]

Nope, I mean the patients that have perfect skin to start with, and then through lack of turning, poor nutrition, poor hydration and general neglect start to develop bedsores while in the nursing homes.

These types of conditions are rampant in nursing homes and nurses (as well as nursing assistants, etc) play a major role.

If I were a nurse manager in an ICU or other hospital unit, I'd need to decide if I wanted to spend the orientation time I'd need bringing a LTC nurses assessment skills, organization and acute care skills up to speed.

You can't take a LTC nurse and put them into a hospital unit with acute patients without a major refresher/reorientation.

If it's a choice between a LTC nurse and a nurse with recent acute care experience, the LTC nurse is at a major disadvantage.

Andrew Lopez, RN
http://www.nursinga2z.com

[WRRN]

Falsifying records is never blurry.. Falsifying records is an intended violation of nursing standards. It has nothing to do with work load. And would never hold up in court of law. "I was so busy I had to put down the wrong number in the chart"??????? If you can't remember the number do it again.. There is always your left hand to write on if you have to.

Unacceptable.


WR,,, three commas for Becca

[lam]

[ QUOTE ]
WRRN said:
Falsifying records is never blurry.. Falsifying records is an intended violation of nursing standards. It has nothing to do with work load. And would never hold up in court of law. "I was so busy I had to put down the wrong number in the chart"??????? If you can't remember the number do it again.. There is always your left hand to write on if you have to.

Unacceptable.


WR,,, three commas for Becca

[/ QUOTE ] agree but why are we not trying to rectify the real problem?