am in between shifts right now, so I should technically be asleep. but of course i'm not, and as always I will regret it come 5pm. But I just had to vent. STUPIDSTUPID STUPID ADMINISTRATION I HATE YOU.
Daily weights. Some patients are on them. Seems simple enough, right?
We used to have to put daily weights in the bedside chart for the day. That's fine, put them in one place, no problems there.
Then my hospital got dinged by the Department of Health because no one was putting weights in the computer. Pharmacy uses those weights to check dosages of weight based medications, so yes, it made sense. Management decided that no one could put any orders into the computer before a height and weight were put in... secretaries started beating us over the head every time we got a new admit. But we complied, because it made sense.
A spot for height and weight showed up on the new admission forms for us to write in. Uh.. okay. Makes sense, admission form should show everything, why not the weight?
Another spot suddenly popped up on our care maps.... getting a little weird now, if I want to know the admission height and weight I'll just, I don't know, look in the bedside chart? NOT THAT HARD.
Then there was an incident where a patient lost like 30 pounds over the course of his stay (it was weeks) and the weight was never updated in the computer, so pharmacy didn't know and sent a dose of med that was somewhat much for the patient. No major harm done, but hospital got dinged again.
The weekly weight saga began.
Every week on wednesday morning, every patient in the hospital gets weighed. Doesn't matter if you are working a skeleton shift, everyone gets weighed.
Our unit tried to split it up and make it easier for the staff by doing one side of the hallway on tuesday and the other on wednesday.... management gave us a big fat no on that one. Why? IDEFK.
But being the good little peons we are, we complied. Now we have 95% compliance with this... but management is still going to be up our asses on this until we have 100% compliance for 3 months straight. (I really think the other 5% are patients who refuse and patients who can't get out of bed and don't have a bed scale, so there is no way this is ever going to happen). Basically we are going to have to deal with this forever.
Seems like a lot of places where I have to write one damn weight.
BUT WAIT.
New Form #90348639046 popped up. WEEKLY WEIGHT FORM! :D A patient on daily weights must have them documented in the bedside chart AND the weekly weight form, which is basically a plotted graph where we can track a patients progress. "So the doctors can see how the patient is losing weight." Um. Weren't we tracking weights just fine before? But noooooo.... this time we have to MAKE A GRAPH! and only the RN can PLOT POINTS! And CONNECT THE DOTS! Because drawing is serious business.
I was kind of disgusted by this point. Another redundant form does nothing for the patient but keeps the bigwigs happy. But as a good little worker I did as I was told.
Then, last week during useless meeting #43634, our assistant manager happened to pass this on. "By the way, those weekly weight graphs don't stay with the chart when the patient is discharged. You give them to the patient."
Hold up.
After nagging us for months to comply with these forms, you are telling us they are basicaly the equivalent of garbage? These forms are not necessary for any legal purpose, because they don't stay with the chart, so basically they are worth nothing. Half the patients I talk to (because we are to show each patient their personal graph!!111one) don't give a damn as long as you tell them the Lasix is working, the other half already know because they can actually see themselves losing water and are just relieved to be going home.
AND THERE'S MORE
This week. new form. Yes, oh yes, it is the WEIGHT FLOW SHEET. It goes in everybody's medex! And! Yes! Wow! It is... a flow sheet for weights. Which means.... every time you weigh a patient, it has to go on that sheet. Um.... yes. DON'T WE HAVE THAT ALREADY. THAT'S WHAT I SAID.
This makes a total of 5 places where you have to write the weight on your standard CHF admission. 6 if you count typing it into the computer.
By the way, our only standing scale broke this weekend. We've been asking for a new one for months.
MAYBE IF WE DIDN'T HAVE SUCH A CRAPPY-ASS SCALE WE COULD HAVE 100% COMPLIANCE.
I'm so disgusted. Time for naps.