Chart all day–CYA

3 Jun

Part of what makes the work in health care so much more stressful is the fact that some people are: sue happy, reject the fact that death is a part of life, and ignore the fact that doctors are humans too.

I just got finished reading part 1 of  WhiteCoats trial story and I am actually depressed.  I see it all the time at work: to the point that you can almost smell a potential lawsuit in the future with some family members as if they are just waiting for something bad to happen to their loved one. I have had family members sit in the room for 12 hours with a notebook, and write down:my name,  the time I came in the room, vital signs, medications given, almost everything I say, how I turned the patient, and so on and so on. It really is a hindrance to patient care because it does not make me go into the room and spend more time with the patient/family, in fact I just want to run away from those rooms and enter only out of necessity…and it compels me to sit down at the computer and chart all day about every minute detail just in case something happens and find myself, the doctor and the hospital in court.

And when you multiply this times all your patients, every shift,  whether or not the family smells like a lawsuit: you spend more time charting and less time providing emotional support and all the extra comfort that could be included in your care plan.  Because in front of the experts no one is going to care that you were holding your patients hand and giving a back rub.

And if you ever find yourself in that situation: the only thing that you will have is your charting, and unless something exceptional about a patient sticks in your mind, you probably will not even remember anything without looking at the chart. Of course we are all accountable but not infallible. Medicine is not a perfect science, it is not the end all, and every body is different. There are standards that will all strive to meet and even go above that, but we are humans.

The whole process is so dynamic, but the fear of being sued or labeled: negligent, or incompetent has got us nurses in chart overdrive. It is a bit overwhelming and this medical sue happy culture sucks: we even have our own acronym for this charting. It is called CYA–cover your ass, charting. I would much spend that time teaching my patients more, and providing the much needed emotional support as well and the medical interventions.

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3 Responses to “Chart all day–CYA”

  1. Gemma June 4, 2009 at 12:47 #

    This post is so depressing yet reflects nothing but the truth. We’re like nursing the charts more than the patients =(

    • seejanenurse June 6, 2009 at 01:15 #

      I know, it gets depressing. I often feel so stressed out, like I just do what I can to get by.

  2. Hua June 4, 2009 at 23:01 #

    Hi Jane,

    Very insightful post.

    I’m Hua, the director of Wellsphere’s HealthBlogger Network, a network of over 2,000 of the best health writers on the web (including doctors, nurses, healthy living professionals, and expert patients). I think your blog would be a great addition to the Network, and I’d like to invite you to learn more about it and apply to join at http://www.wellsphere.com/health-blogger. Once approved by our Chief Medical Officer, your posts will be republished on Wellsphere where they will be available to over 5 million monthly visitors who come to the site looking for health information and support. There’s no cost and no extra work for you! The HealthBlogger page (http://www.wellsphere.com/health-blogger) provides details about participation, but if you have any questions please feel free to email me at hua@wellsphere.com.

    Best,
    Hua

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