Monday, July 13, 2009

I dont have to think so I cant be accountable!

Beeper keeps going off. There is a new JACHO policy about pain medications, you cant write in the post op orders, Morphine Sulfate 1 to 4 mg IV q 2 hours prn pain. You must write, if pain on pain scale is 0-1 give no morphine. If pain is 1-3 give 1 mg morphine 1v. If 3-4 give 2, and so on. Gone are the days when the nurse was able to watch the patient and keep them comfortable by asking them about their pain and watching their vitals using their experience and wisdom to guide them. Now the attitude is dont let the nurse think, just let them do paperwork. If they dont have to use judgement then they dont have to be accountable.

Oh, I forgot, before the pain medication can be given, the nurse must document what pain was on the pain scale. I know that most of my patient who are waking up from surgery are in pain but can only raise one finger to show their pain scale. It is of course the middle finger which is raised when they are shook violently to wake them up so you can ask them about their pain scale.


Andrew_M_Garland said...

Hey, not thinking, not reading, and not being an expert works for Congressmen and Senators.

You can't be sued if you aren't an expert. The defense is "You had no reasonable expectation of a good outcome, knowing that I didn't know anything".

SeaSpray said...


I'm concerned that patients are more at risk if nurses are more focused on their computers. Or that they could suffer needless pain.

There is something to be said for an experienced, competent, compassionate nurse at your bedside.

I think people heal better when they experience compassion and positive staff.

Oh gosh..I hope I never gave anyone the middle finger! You were being facetious..right?

I always had the impression..I just woke up. (Darn Versed!) Matter of fact... I am awake and hear a lot BEFORE I can open my eyes or move. I think they think I am sleeping because I have heard some conversations about me they wouldn't say if I was awake.

Judgment or not... they're accountable.

If I were a nurse...I'd be very frustrated that I couldn't be as hands on with my patient. They don't become nurses to push the paperwork..unless administrative.

I think I told you that last summer, the night my mother was a patient in ER..the ER doc (I had worked with him)was telling me how they ...the drs are timed and have to see all the patients in a short amount of time. (I didn't ask.. but you know they have to stop to document that somewhere) It was a new regulation he was NOT happy about. He sid they couldn't spend as much time with the patients. They do bypass when hung up in major emergencies.

I just think it is all so crazy. It doesn't have to be. I am concerned with this current administration and if they get their way with health care... it will become even more complicated.

Flarin' Karen said...

How do you pronounce JACHO anyway?

When I read it to myself I say "Jake-OH" but I suppose it could be Jack-ho.

Andrew_M_Garland said...

From other posts, I think it is pronounced "idiots".

SeaSpray said...

Funny Andrew! :)

SeaSpray said...

Throckmorton -what did u think of President's discussion on healthcare?

He paints a good picture and seems so sincere and well meaning... but misrepresented or omitted some things... IMO. :)